Management of a severe hypoglycaemia

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If a low blood glucose is not treated, or not recognised the blood glucose may fall further, and result in the person becoming unconscious and have a fit / seizure / convulsion.

A severe hypo (when the child is unconscious or fitting), must be treated immediately with an injection of Glucagon using the Glucagen HypoKit.

Glucagon is a hormone that is produced in the pancreas. It raises the blood glucose levels by stimulating the release of the stored glucose from the liver.

Glucagon is a drug prescribed for an individual patient and must only be given to the named individual.

Management of severe hypo:

  1. Seek a responsible person to:
    • Dial 999, ask for a paramedic ambulance crew and state that the person is having a severe hypoglycaemic episode.
    • Collect the Glucagen HypoKit.
  2. If unconscious, place in the recovery position (lay the child onto their left side with mouth downwards and chin up), ensure that they are safe and do not give anything by mouth.

Figure 1: Recovery Position

patient placed in the recovery position to ensure a clear airway for adequate breathing and to prevent inhalation of vomit.

patient placed in the recovery position to ensure a clear airway for adequate breathing and to prevent inhalation of vomit.

  1. Give the Glucagon, following these steps:
  2. Prepare the Glucagon injection by adding all the liquid to the powder.
  3. If your child is over the age of 8 years inject all of the solution or half if your child is under the age of 8 years. Inject into the upper, outer muscle of the thigh or buttock.
  4. Do a blood glucose test whilst waiting for the ambulance to arrive.
  5. Continuing management:
  6. As soon as sufficient recovery has taken place, give carbohydrates.
  7. Nausea, vomiting and a fast heart rate may occur following an injection of Glucagon.
  8. If recovery has not taken place within 10 minutes then an intravenous infusion may be required. The ambulance crew will see to this.

 

The Glucagen HypoKit should be stored in the fridge. Most families opt to take the Glucagen Hypokit with them if going on holiday. Once out of the fridge it will last at room temperature for 18 months (or until expiry on kit if this is sooner).

It is advised that you also have a hypo box made up for easy access. This hypo pack should include the following:

  • Glucogel (formerly known as Hypostop Gel), Lucozade tablets, a sweet drink and biscuits / cereal bars.
  • The Glucagon injection and any other items within the emergency pack must be replaced after use and when they expire.

 

If you should have to use the Glucagen Hypokit ensure used equipment is disposed of appropriately.

Please let your Diabetes team know if you have had to use the Glucagen Hypokit as we need to keep a record of severe episodes of hypoglycaemia, and would like to discuss how we can prevent it happening again.

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