OCEMS DEXTROSE

Medication Overview

• Medication: Dextrose

• Classification: Carbohydrate

Treatment Protocols

Adult Protocol

• Indication: Altered Mental Status

• Protocol: Treat a blood glucose of 60 or less using 10% Dextrose 250 mL Intravenous (IV), titrated for effect to improve consciousness.

Pediatric Protocol

• Indication: Altered Mental Status

• Protocol: Treat a blood glucose of 60 or less using 5 mL/kg of 10% Dextrose IV, with a maximum dosage of 250 mL, titrated for effect to improve consciousness.

Effects/Characteristics

• Elevates Blood Glucose Level

• Potential Side Effects:

  • Hyperglycemia

  • Dehydration

  • If injected into interstitial tissues; damage can occur.

• Sclerosing Effect: Marked effect on veins can lead to complications if not properly managed.

Pharmacokinetics

• Onset: 1 minute

• Peak: Duration dependent on blood glucose levels and underlying causes.

• Duration: Also varies based on blood glucose levels and underlying causes.

• Safety: D10 is much safer for patients than D50.

• Dosage Adjustment for Pediatrics:

  • If volume given to pediatrics is >100 mL, excess fluid should be removed, leaving the correct dose in the bag.

  • For <100 mL, use a syringe to draw from the IV bag and administer slowly via IV push.

Dosage Form

• Available Forms:

  • 25g/250 mL IV bag (D10)

  • 25g/50 mL PFS (D50)

Prehospital Routes of Administration

• Intravenous (IV): Primary route.

• IV Piggy Back: Can be utilized for administration.

• Intraosseous (IO):

  • If unable to establish an IV, Dextrose can be administered via IO.

  • Administer with caution, ensuring pain is managed (if infusion causes pain, use lidocaine).

Administration Notes

• Monitoring:

  • Monitor IV site for extravasation. Aspirate before and during administration if giving IV.

  • Doses should be titrated to improved mental status.

  • D10 is much safer for patients than D50.