Hypoglycemia

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Seizure overviewStatus EpilepticusEclampsia (pregnancy)OB EmergenciesAlcohol withdrawalToxic ingestionFebrile seizure (peds)Hypoglycemia
Glucose < 70 mg/dL with symptoms — OR < 54 regardless
Definition

Treat immediately. Whipple triad: low glucose + symptoms + resolution with dextrose. Sulfonylurea / long-acting insulin → recurrent / prolonged hypoglycemia (admit).

  • Hypoglycemia (infants/children)

    IV/IO
    IV/IO• 0.1 g/mL• 5 mL/kg

    5 mL/kg D10 = 0.5 g/kg dextrose

  • Hypoglycemia (children)

    IV/IO
    IV/IO• 0.25 g/mL• 2 mL/kg

    2 mL/kg D25 = 0.5 g/kg dextrose

  • Hypoglycemia (adult/large child)

    IV
    Adult: 25 g (1 amp = 50 mL)
    IV (large vein)• 0.5 g/mL• 1 mL/kg

  • Hypoglycemia, no IV

    IM/SQ
    Adult: 1 mg IM
    IM/SQ• 1 mg/mL• 0.03 mg/kg
Rule of 50
Concentration × mL/kg = 50 → 5 mL/kg D10, 2 mL/kg D25, 1 mL/kg D50. Goal: 0.5 g/kg dextrose.