Indications:
Altered mental status caused by hypoglycemia, defined as:
- Adults:
- Diabetics = POC glucose analysis less than 110 mg/dL or symptomatic
- Non-diabetics = POC blood glucose analysis less than 80 mg/dL
- Children:
- Diabetics = POC blood glucose analysis less than 70 mg/dL or symptomatic
- Non-diabetics = POC blood glucose analysis less than 70 mg/dL
- Neonates:
- POC blood glucose analysis less than 45 mg/dL
Contraindications:
- Absent gag reflex
- Patients who are unable to protect their airway
- Patients who are unable to swallow
Precautions:
- Assure gag reflex is present prior to administration
‡For young infants and children, the child should be sitting upright or in the recovery position, and the gel should be massaged into the cheek pocket mucosa
Side Effects: Aspiration
Adult Dose:
Standing order (*based on 15-gram unit dose):
Hypoglycemia:
- *One full tube (15 g), administered in small increments
- May repeat once after 15 minutes
Pediatric Dose:
Standing order (*based on 15-gram unit dose):
Hypoglycemia:
- 0.5 grams/kg, administered in small increments:
AGE
APPROX WT
DOSE
Infant (31 days to 1 yr)
Under 10 kg
5 mL‡
1 yr to 3 yr
15 kg
7.5 mL‡
3 to 5 yr
20 kg
¼ tube*
5 to 7 yr
25 kg
½ tube*
At least 7 yr
30 kg
1 tube*
- May repeat once after 15 minutes
- *Based on 15-gram unit dose
Neonatal Dose:
Standing order for neonatal hypoglycemia for infants up to 30 days of age:
Hypoglycemia:
- 0.2 g/kg (0.5 mL/kg) massaged gently into the mucosa of the cheek cavity
How Supplied:
40% Gel (15 grams in 1.3 oz. (approximately 37.5 g))
*NOTE: Agencies carrying a different size unit dose will need to adjust dosing accordingly, especially for pediatric patients
Route: Oral (buccal cavity between the gums and teeth, not the posterior oropharynx) Increases blood glucose level
Drug Action: Increases blood glucose level
Class: Carbohydrate
Onset: 1 minute
Duration: Depends on the degree of hypoglycemia