D50: All or Some?

[EMS49393]

Mobey,

We carry 500 ml and 1000 ml bags, so diluting would really only work if we had an extended transport, and needed to maintain the glucose level. When I administer dextrose, I push 6 mg (12 ml) into a 60 ml syringe, than draw 48 ml out of a bag of normal saline. I do this twice, and I can give 12 mg of dextrose within a few minutes with little fear of rendering my IV useless.

Off the topic of D50W, I dilute my promethazine in a 30 ml syringe. We get 25 mg/ml doses. I draw 29 ml of normal saline, plus the ml of promethazine. I can then either administer 12.5 mg or the full 25 mg, slowly. I'm sure you know that promethazine can cause a dystonic reaction if pushed too fast. It is also extremely caustic to the vein, and downright painful if you don't dilute it.

Perhaps a spin-off thread: "To dilute, or not to dilute."

[saboats]

Like the idea of a spin off for phenergan IVI. We dilute 12.5mg in 50cc NACL and infuse at 10cc/min, limits the risks, and discomfort for the paitent. Great idea to through this into the post...

[AZCEP]

I'm sure you mistyped, but you only use 6 milligrams of dextrose?

[EMS49393]

When I administer dextrose, I push 6 mg (12 ml) into a 60 ml syringe, than draw 48 ml out of a bag of normal saline. I do this twice, and I can give 12 mg of dextrose within a few minutes with little fear of rendering my IV useless.

No, you misread.

[AZCEP]

Since the typical dosage of dextrose is in GRAMS, not milligrams, are you sure about this?

[northernmedic]

We have been using D10W to treat hypoglycemia in my service for well over 15 years now. In my opinion it has several benefits such as a more gradual increase in blood glucose as well preventing a big spike then a big drop. In addition you can provide a small maintenance infusion to help maintain blood glucose if the person is unable to tolerate food PO. We carry it in 500cc bags and typically give it in 100cc bolus' titrated to effect (blood glucose >4.0 mmol/L or improvement in mental status). There was a study done in the UK comparing D10W to D50W for treatment of hypoglycemia. I will track it down on Pubmed tomorrow when I'm at work.

[EMS49393]

My error, I've dropped not less than 40 IQ points since relocating to the armpit of the country. 12 Grams. I can only imagine how good it must feel to call a person out in public rather than by PM. How proud you must be of yourself. I'm sure you're a stellar example of an instructor, no doubt as qualified as the one I have teaching my refresher this month. :roll:

[Ridryder 911]

My error, I've dropped not less than 40 IQ points since relocating to the armpit of the country. 12 Grams. I can only imagine how good it must feel to call a person out in public rather than by PM. How proud you must be of yourself. I'm sure you're a stellar example of an instructor, no doubt as qualified as the one I have teaching my refresher this month. :roll:

Hey, you are the one that continued to make the mistake... You get that type of attitude with QI, when you make that mistake in charting? ..

R/r 911

[firedoc5]

AZCEP wasn't calling you out, he was just pointing out an error for your benefit and others that might not have caught it. When dealing with professionals you have to expect that.

[Ghettomedic351]

Since the typical dosage of dextrose is in GRAMS, not milligrams, are you sure about this?

AZCEP.....wow what a dandy you are.....you and your Christ like intentions....do you walk on water also? Do you ever make mistakes? Remember those who can do! Those who cant teach. I personally think you are a phony as you seem to be on here posting all the time. Question for you,with all the post's you make when do you have time to work or teach?