Drinking D50

[MeekoBB]

There is one medic crew here by me that sometimes have the pt drink the D50. I was taken aback by it.

[kevkei]

From a pharmacological perspective, dextrose is dextrose regardless of it's form.

From a technical perspective, you are administering an IV medication via an oral route. I doubt the pharmaceutical company approves IV D50W for P.O administration.

The pizza is a good ideal. We all too often load patients up with simple sugar (carbohydrates ) which will plateau and then fall off. You should also remember to add complex carbohydrates as well as protein to the mix to maintain a decent BGL.

[AZCEP]

Nutrition 101 coming back on me.

The sugar that is found in most food is not dextrose specifically. Most will be fructose or sucrose, which will require some degree of catabolism before the body can use it. As I can understand it, using D50 P.O. will reduce the amount of the dextrose that is absorbed, thereby reducing the expected increase in blood glucose level. It will work, just not to the degree that IV will.

Pizza is a good mix of the major macronutrients and is often quite easy to convince someone to eat. Peanut butter and jelly is a reasonable alternative, but keep in mind there is more of a sugar load that can wear off a bit faster. I've found it works very well following the use of Glucagon though.

[ERDoc]

All of this talk about food makes me want to go out and get a nice pie with some roni.

[brentoli]

I just ate a pizza. Anyone wana prick me?

[UMSTUDENT]

1 gram of carbohydrate= 4 calories. Therefore 25 grams of 50% Dextrose is equivalent to roughly 100 calories.

This isn't rocket science either; rather you can find it on the side of your cereal box. You're basically shoving an apple down someone's throat when you give them D50, minus the whole digestion thing.

[paraloco]

I've had more than one hypoglycemic patient who was also profoundly hypothermic. Anyone else seen this?

[vs-eh?]

For those that have given D50 PO.....

1) Do you have a standing order/patch order that allows you to give this solution by this route?

2) If you do not, do you inform your medical director prior to administration (i.e. patch) or inform them ASAP following the call? What do they say?

You are administering a medication (regardless of its "flexible" definition for D50) via an unapproved route I assume by both the manufacturer and by your standing orders. If D50 was "ok" to give PO, then you would have orders saying so in your "able to follow commands, hypoglycemic patient". This would be given of coarse that you don't have ready/reasonable access to a food source/glucose gel, and basically as a last resort. I hope people aren't regularly giving "ok", but hypoglycemic patients D50 orally...

I would think if administration PO was "acceptable", even in a "no other option" scenario that you would have orders/manufacturer guidelines saying such...I assume most/all do not.

[emtgal40222]

There is one other route that is gross, but if no venous access you can always go rectal. It causes a big mess, but with an unconscious, unresponsive BS<50, I saw almost immediate results. Just one more option.

[Ridryder 911]

Vs-Eh is right deviating from standard route one might want to get an order. Another medication, that is routinely administered p.o. is Lasix (IV form) and many others .. albeit, I would not recommend, unless approved.

R/r 911