Bonner County EMS System Patient Care Treatment Guidelines-Medical Emergencies & OB/GYN Medical Emergencies: Hypoglycemia - 7035 HYPOGLYCEMIA HISTORY Known diabetic, medic alert tag Past medical history Medications Change in responsiveness/condition Disorientation SIGNS AND SYMPTOMS Decreased mental status or lethargy Change in baseline mental status Bizarre behavior Hypoglycemia (cool, diaphoretic skin) Hyperglycemia (warm, dry skin; fruity breath; Kussmaul respiration; signs of dehydration) Irritability Lowered gross motor or deep tendon reflexes Glasgow Coma Scale <14 ASSESSMENT CNS (stroke, tumor, seizure, infection, trauma) Hypothermia Infection (CNS and other) Thyroid (hyper / hypo) Shock: septic, metabolic, trauma Diabetes (hyper/ hypoglycemia) Toxicologic or ingestion Acidosis / Alkalosis Pulmonary (Hypoxia) Electrolyte abnormality Psychiatric disorder TREATMENT GUIDELINES R-EMR E-EMT A-AEMT P-PARAMEDIC **M-Medical Control ** ***Higher level providers are responsible for lower level treatments*** Initial Patient Contact (2000). Oxygen Administration (9000) 10-15 L via non-rebreather (NRB). Glascow Coma Scale (A2). R Consider ALS assist with cardiac monitor and 12-lead EKG (9030) if indicated. Transport to receiving facility, with ALS intercept. E Blood Glucose Analysis (9040); for glucose <60 and awake with patent airway, administer 1 tube Oral Glucose PO/SL (buccal). 2 Reevaluate blood glucose; may repeat Oral Glucose if ALOC and or glucose <60 remain. 2 Establish IV with NS, draw labs; do not delay transport for IV access. 2 If Paramedic is not on scene or expected within 10 minutes and lungs are clear, consider IV D5W, 5 cc/kg, and check for breath sounds after giving bolus. 2 For glucose <60 and patent IV, administer 12.5-25 gm of 50% Dextrose A ____________________________________________________________________________________________________________ BCEMS Medical Director Effective: 4/1/14 final 2/26/2022 page 1 of 2