Hi All, I'd like some people's insight into this call. Picked up a 60 y/o male this morning who was unresponsive...BGL was 1.9 mmol/L. I started a line then gave D50. Sugar came up to 3.0mmol with improvement in LOC. Everything else checked out relatively normal. Pt has hx of chronic subdural bleeds, NIDDM, and A Fib. He's also a bariatric patient.
His temp was 37.8C
BP - 130/66
SPO2 - 100% with 6lpm via Simple
Pulse 66-88bpm
ETCO2 - 37
En route to the hospital, his sugar once again dropped to below 2 mmol. Gave another amp of D50, along with the hanging D5W. Long story short, his sugars dropped twice more, and gave D50 each time, and it would come back up, but then start to drop again. We got him to the hospital and they did their usual blood work and CT. CT was unchanged from about 3 weeks previous. All blood work was within normal ranges. Insulin level was also fine.
I just don't know about this one, it just threw me off, and had no idea what to think of it. Any ideas? If I find out more, I will let you guys know. Thanks!
His temp was 37.8C
BP - 130/66
SPO2 - 100% with 6lpm via Simple
Pulse 66-88bpm
ETCO2 - 37
En route to the hospital, his sugar once again dropped to below 2 mmol. Gave another amp of D50, along with the hanging D5W. Long story short, his sugars dropped twice more, and gave D50 each time, and it would come back up, but then start to drop again. We got him to the hospital and they did their usual blood work and CT. CT was unchanged from about 3 weeks previous. All blood work was within normal ranges. Insulin level was also fine.
I just don't know about this one, it just threw me off, and had no idea what to think of it. Any ideas? If I find out more, I will let you guys know. Thanks!
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