ScenarioA 28-year-old male patient is brought in who has an altered mental status after crossing in the top 10 runners. His running partner said that he had been getting worse as he ran. The patient does have an elevated heart rate, his BP is 132/88, and his respiratory rate is 28. The patient does not feel hot or warm to the touch, and a rectal temperature rules out heatstroke because the temperature is only 100.2°F (37.8°C). A review of the patient’s race forms reveals that he has type I diabetes. A blood glucose measure indicates his blood sugar is 40 mg/dl. The patient is continuing to decline and is unable to control his airway in order to drink fluids. You have activated your EAP (emergency action plan).
Would you use glucagon initially or attempt to establish IV access and administer D50 or D25?If you administered D50 or D25 IV, what gauge IV catheter would you use?What response would you expect your patient to have from the administration of IV dextrose?