How is hypoglycemia during arrest managed?

How is hypoglycemia during arrest managed?

• A. Administer IV dextrose if hypoglycemic; monitor glucose and treat accordingly.
• B. Withhold glucose
• C. Administer glucagon only
• D. Use insulin

Answer: (A)

When hypoglycemia is present during arrest, the priority is to rapidly raise blood glucose to support brain and heart function. The fastest and most reliable way to do this is to give intravenous dextrose. Administer a bolus of 50% dextrose (typically 25 g) IV, then monitor the glucose level and treat accordingly. If IV access isn’t immediately available, establish intraosseous access and deliver dextrose there, with ongoing glucose monitoring and repeat dosing as needed to achieve and maintain euglycemia. Withholding glucose would deprive the brain and heart of needed energy and worsen outcomes. Using insulin would lower glucose and worsen the situation, and relying on glucagon alone is not as effective in producing a rapid, adequate rise in glucose during an arrest.

When hypoglycemia is present during arrest, the priority is to rapidly raise blood glucose to support brain and heart function. The fastest and most reliable way to do this is to give intravenous dextrose. Administer a bolus of 50% dextrose (typically 25 g) IV, then monitor the glucose level and treat accordingly. If IV access isn’t immediately available, establish intraosseous access and deliver dextrose there, with ongoing glucose monitoring and repeat dosing as needed to achieve and maintain euglycemia.

Withholding glucose would deprive the brain and heart of needed energy and worsen outcomes. Using insulin would lower glucose and worsen the situation, and relying on glucagon alone is not as effective in producing a rapid, adequate rise in glucose during an arrest.