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Medical

HYPERGLYCEMIA

Signs and Symptoms: Differential Diagnosis:
• Polyuria • DKA (Ketoacidosis)
• Polydipsia • Hyperosmolar Hyperglycemic
• Weakness, fatigue Syndrome (HHS)
• Nausea, vomiting • Head Trauma
• Change in LOC • Stroke
• Hypotension • Hypo/Hyperthermia
• Tachycardia • Toxic Exposure
• Seizures, coma
• Fruity Breath Odor
Universal Patient Care Guideline
O 2 (if Hypoxemic)
Continued from: IV/IO Guideline
Tactical Evacuation Guideline Cardiac Monitor
BLOOD GLUCOSE ANALYSIS
Altered Metal Status with Consider Intubation
labored breathing YES AIRWAY Guideline
Blood Glucose >250 Continuously
1000ml .09% NS YES
(10-20ml/kg IV Bolus) Verify Blood Glucose Analyzer reassess neuro
is accurate and pulmonary

12-Lead ECG Monitor Blood
Observe and monitor for signs and Glucose
symptoms of electrolyte reanalyze q30min
imbalances (Hypokalemia)
Hypotension and Tachycardia? YES
Arrhythmia? Hypotension/Shock Guideline
NO
YES Nausea/Vomiting? YES
Bradycardia Tachycardia
with Pulse with Pulse
g
NO Promethazine 12.5–25mmg IV
OR
Cardiac Arrest Ondansetron 4-8mg IV
(VF/Pulseless VT or
Asystole/PEA) When appropriate, return to:
Tactical Evacuation Guideline
Or Appropriate Guideline by Complaint
Pearls:
• If insulin is available, treat with low dose infusion, 0.1units/kg/h
• Too rapid drop in blood glucose can cause hypoglycemia.
• Rapid drop in blood glucose levels can lead to shifts extracellular osmolality which can lead to cerebral edema
• The most common electrolyte imbalance is hypokalemia.
• Identify and treat underlying cause (infection, trauma)

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