It’s the end of the year, snow is falling, cookies are baking, and everyone’s blood sugar is a bit high. My holiday gift for all of you is – you guessed it! – one more protocol, and a topical one at that! Let’s round out the year with Protocol 512 – Hyperglycemia , attached below.
Once again, the protocol leads off with ABCs, including a referral to advanced airway management for patients who may be inadequately ventilating. After that primary survey, crews will check a fingerstick, with subsequent management reserved for patients who are hyperglycemic over 500 mg/dL, or over 300 mg/dL with concomitant symptoms. Treatment consists of bolusing up to 1L of IV fluids (or 20mL/kg for peds) by Standing Order, with an additional bolus permitted as a Medical Control Option after getting OLMC approval. Insulin administration is not included in these protocols, which makes sense considering short transit times and inability to measure potassium levels.
That’s it! As 2020 comes to a close, we’re unfortunately left with a few protocols left uncovered prior to the big 2021 overhaul, and while I’m sure you’ll all miss them dearly, we’ll be sure to cover the content in the fancy new protocol formatting in the coming weeks. Stay tuned! Until then, have a terrific, safe holiday… and if you’re inspired, check out www.nycremsco.org while sipping on some hot cocoa!
Dave