# Most glutose administered to a patient



## rhan101277 (Aug 8, 2011)

I wanted to see how many of you have administered more than 2 (15g) oral glutose to one person.


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## Shishkabob (Aug 8, 2011)

I've only ever done 1 tube to a patient.  Typically they get a mix of glucose (or D50, or Glucagon) and then when able... real food / orange juice / soda.


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## Tommerag (Aug 8, 2011)

Linuss said:


> I've only ever done 1 tube to a patient.  Typically they get a mix of glucose (or D50, or Glucagon) and then when able... real food / orange juice / soda.



Same here


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## Sam Adams (Aug 8, 2011)

Generally only give one. Typically administered while someone is making a peanut butter and jelly sandwich or something. I have given three a LONG time ago. Never again though. It upset their stomach so much they vomited, and let me tell you, oral glucose vomit is not, NOT easy to clean.


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## rhan101277 (Aug 8, 2011)

Well I gave three last night over the span of 1 hour without any vomiting.  Then pt ate a meal and drank fluids.  It took more because initial CBG was 19 after 10 minutes it was 41 and another 30 it was 63.


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## reaper (Aug 8, 2011)

Why not go to D10 or D50? That is a long time to sit with a BGL that low.


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## YoungMedic (Aug 8, 2011)

^^agreed


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## Nerd13 (Aug 8, 2011)

I've seen three given before. No IV sites available. Pt still alert but not oriented. Able to protect airway and had no trouble consuming the first tube. Initial BGL was in the 20s. We made it as high as the 50s by the time we got to the hospital but the pt was fully alert and oriented.


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## rhan101277 (Aug 9, 2011)

Nerd13 said:


> I've seen three given before. No IV sites available. Pt still alert but not oriented. Able to protect airway and had no trouble consuming the first tube. Initial BGL was in the 20s. We made it as high as the 50s by the time we got to the hospital but the pt was fully alert and oriented.



yeah my patient was like this, alert but not oriented and it was coming up.  my patient did not want to go to hospital.

Three IV attempts failed, pt alert enough to say paramedics always fix me and pt had dr. appt in a couple of days. 

Family also adamant on not transporting.


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## NomadicMedic (Aug 13, 2011)

rhan101277 said:


> yeah my patient was like this, alert but not oriented and it was coming up.  my patient did not want to go to hospital.
> 
> Three IV attempts failed, pt alert enough to say paramedics always fix me and pt had dr. appt in a couple of days.
> 
> Family also adamant on not transporting.



Why no Glucagon?


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## StickySideDown (Aug 25, 2011)

I've given three tubes over the course of 20 minutes without vomiting.

Pt was AAOx3, First BGL was in the low 20s, gave one tube, waited 5 minutes and then we were in the upper 40s. Gave one more tube, dropped back down into the 20's. Gave a third tube. Arrived at the hospital.

Medics unable to get an IV started anywhere after multiple attempts in the arms, hands, and feet throughout the whole process.


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## epipusher (Aug 28, 2011)

also curious as to why no glucagon is being given in some of these situations


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## NomadicMedic (Aug 28, 2011)

StickySideDown said:


> Medics unable to get an IV started anywhere after multiple attempts in the arms, hands, and feet throughout the whole process.



That's why there is IM Glucagon.


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## usafmedic45 (Aug 28, 2011)

Nerd13 said:


> I've seen three given before. No IV sites available. Pt still alert but not oriented. Able to protect airway and had no trouble consuming the first tube. Initial BGL was in the 20s. We made it as high as the 50s by the time we got to the hospital but the pt was fully alert and oriented.



Glucagon?


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## firecoins (Aug 28, 2011)

If they aren't orientated, they have to go to the hospital. Why spend 40 minutes on scene?


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## DESERTDOC (Aug 30, 2011)

I never have given tube glucose.  The only time I needed some PO glucose, my EMT helped the man with some orange juice, I made him a nice fat turkey and swiss on cracked wheat, with purple onion and mayo and watched him eat the whole thing.  He was fine in 20 minutes.

C-4 PRS AMA.


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## usafmedic45 (Aug 30, 2011)

DESERTDOC said:


> I never have given tube glucose.  The only time I needed some PO glucose, my EMT helped the man with some orange juice, I made him a nice fat turkey and swiss on cracked wheat, with purple onion and mayo and watched him eat the whole thing.  He was fine in 20 minutes.
> 
> C-4 PRS AMA.



You don't have a lot of experience then do you?


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## ArcticKat (Aug 30, 2011)

What is Glutose?  Is that a trade name or just a case of a medic not knowing the medication he's providing?

I've never had to give more than one tube of glucose.  If the patient has an altered LOC they get transported.  Glucagon if they're unable to take anything orally.


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## Lady_EMT (Aug 30, 2011)

I've given two, then the medic showed up and gave a third, and the pt was drinking orange juice during the whole thing. 

Pt ended up vomiting, But she did so late enough that most of the sugar was able to be absorbed. 


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## medic417 (Aug 30, 2011)

ArcticKat said:


> What is Glutose?  Is that a trade name or just a case of a medic not knowing the medication he's providing?
> 
> I've never had to give more than one tube of glucose.  If the patient has an altered LOC they get transported.  Glucagon if they're unable to take anything orally.



Google glutose you will find it.  

http://www.google.com/#hl=en&sugexp...gc.r_pw.&fp=c006a4cc1709ec9c&biw=1280&bih=628


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## ArcticKat (Aug 30, 2011)

medic417 said:


> Google glutose you will find it.



Wish I woulda thought of that before I posted.   Thanks.


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## medic417 (Aug 31, 2011)

ArcticKat said:


> Wish I woulda thought of that before I posted.   Thanks.



Your welcome.  :rofl:


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## Melclin (Aug 31, 2011)

I don't understand you blokes transporting so many diabetics. The discharge criteria of EDs is the identification of a cause and the quick resolution of symptoms. Vast majority of cases fit this criteria. Even if the cause isn't overt, mostly its an issue for the GP. AMA/refusal aside. 

I avoid the glutose tubes like the plague. They taste terrible. *Does anybody know why they haven't made something a bit more appetising?* I've been wondering that for a while. There is usually something in the pt's house. One tube at the most. Given how long you have to wait for the tubes to work I don't think I fancy leaving a person with a symptomatically low sugar for more than one tubes worth of waiting time before dextrose/glucagon.




firecoins said:


> If they aren't orientated, they have to go to the hospital.



Why?


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## ArcticKat (Aug 31, 2011)

Melclin said:


> They taste terrible. *Does anybody know why they haven't made something a bit more appetising?* I've been wondering that for a while.



I've been told by our medical advisors that Cakemate, a brand name for a squeeze tube of cake icing would be an excellent replacement for oral glucose.


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## usafmedic45 (Aug 31, 2011)

> Does anybody know why they haven't made something a bit more appetising?





> I've been told by our medical advisors that Cakemate, a brand name for a squeeze tube of cake icing would be an excellent replacement for oral glucose.



It's called honey.  My medical director actually told me I was welcome to carry it on the rig if I so desired.  That was quite alright with me given my habit of drinking tea quite frequently.


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## NomadicMedic (Aug 31, 2011)

Again? Glucagon?


Sent from my iPhone.


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## rhan101277 (Aug 31, 2011)

n7lxi said:


> Again? Glucagon?
> 
> 
> Sent from my iPhone.



If you need to give Glucagon then the patient needs to be transported.  The pt i had was alert and oriented after glutose and drinking juices etc.  If it wouldn't have been increasing and her mental status steadily getting better, I would have given glucagon and transported.


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## epipusher (Aug 31, 2011)

Melclin said:


> Why?



you would leave a patient to care for themselves if they are not oriented as normal??


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