Rectal D50

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crotchitymedic1986

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I am new here, and have been active in another ems forum. Recently a question was posted about the use of Glucagon in the hypoglycemic patient that you can not get IV access for. The question was about what you should do next, if glucagon doesnt work ?

I was shocked to realize that most new medics did not know that D50 can be given orally (but soda is better -- a 12oz coke has 39 gms of sugar versus 25 gms in D50), and that D50 can be given rectally via an ETT tube.

Thought I would share the info in case some in this forum were not aware.
 
Some first responders thought that oral gucose could be given IV (and V in this case does not mean venous) :blink:
 
fma08 said:
some first responders thought that oral gucose could be given iv (and v in this case does not mean venous) :blink:
Click to expand...

tmi!!!!!!!!!
 
Yes, I have given it rectal. I did not use an ETT, I use a foot long piece of O2 tubing. It is smaller, slide up easy and the connector fits the syringe good.
 
Yup - knew that - have used d50 via iv, oral, and rectal. Kinda like the honey bear theory. Or a large sized tootsie roll. We can get pretty ingenious.
 
Those are all great ideas and wow musta been interestingtimes. To bad my protocols don't specify those as routes for my d50
 
Well what if they have some stool up in there?
 
Although going past the rectal vault is the best method it is doubtful that most EMS units carry proper tubing to do such, as well remembering one has to administer 50ml of fluid which is equivalent to an enema. I give it blunt (without tubing) personally, don't care to cause a rectal tear or lacerated bowel. Yes, it works and can be given, just expect other results as well.

In regards to the stool it will loosen and dissolve it and again as mentioned above.

R/r 911
 
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re

sweet and sour enema anybody?

Corky
 
Yeah i have done rectal once and it was on a longer transport....bad idea, I bet the guy felt relieved and a little dirty at the same time. anyways you can and some do but i would go oral first, and airway is much easier and more pleasant to watch than the other way.:rolleyes:
 
Isn't Dextrose caustic to tissues? Wouldn't that cause some sort of damage to the rectum?
 
Our medical director doesnt encourage us to administer anything rectally. We have even went to versed intra-nasal in seizures vs using diazpam rectally.
 
Glucogon will not work if their peripheral circulatory system is shut down.
 
WiFi_Cowgirl said:
Isn't Dextrose caustic to tissues? Wouldn't that cause some sort of damage to the rectum?
Click to expand...
Probably not. It is caustic internally because of the concentration level and being colloid. Remember, mucosa membrane also has aciditic secretions as well.


Emtgirl21 said:
Our medical director doesnt encourage us to administer anything rectally. We have even went to versed intra-nasal in seizures vs using diazpam rectally.
Click to expand...

Versed is a much better medication as it actually ceases the seizure activity itself; Valium only relaxes the muscles and truly does not stop the seizure. Diastat is Valium specifically made for rectal insertion. A syringe type device that has a long tube on the end and has a gel type medication.

R/r 911
 
Why will glucagon not work if peripheral is shut down? How shut down, like blue arms and legs?
 
Glucagon is a hormone that acts on the liver to break down glycogen into glucose and release said glucose into the blood stream (side note: muscle cells also have a stock pile of glycogen, but can't release it. Glycogen is broken down into glucose-6 phosphate and the muscle cells lack the enzyme needed to change G-6P into glucose). If the injected glucagon doesn't reach the liver because there isn't enough bloodflow, then it won't have an effect.
 
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