Last Modified: 9:02am 23/12/2021

SEVERE HYPO -Adults who are unconscious/fitting or very aggressive or nil by mouth (NBM).

• Check ABCDE, stop IV insulin, request medical support urgently.
• Give 100ml 20% dextrose or 200ml 10% dextrose over 15 minutes.
• If IV access not possible use 1mg Glucagon IM*.
• Recheck glucose after 10 minutes and if still less than 4.0mmol/L, repeat treatment as above.
• If glucose now 4.0mmol/L or above, follow up treatment as described on the left. If NBM, once glucose >4.0mmol/L give 10% glucose infusion at 100ml/hr until no longer NBM or reviewed by doctor.

*Glucagon may take up to 15 minutes to work and may be ineffective in treating hypoglycaemia in undernourished patients, in severe liver disease, sulfonylurea induced hypoglycaemia and in repeated hypoglycaemia.