Hypoglycaemia

Low complexity — Central Nervous System

Goals

  1. Recognise a compromised airway due to reduced consciousness using the ABCDE method.
  2. Name the treatment for hypoglycaemia and apply it.
  3. Recognise and describe hypoglycaemia.

Anamnese

  • Name: Mr de Jong
  • Age: 68 years
  • Family: Single
  • Occupation: Retired
  • Cultural: Not known

AMPLE

A: Unknown

M: Acetylsalicylic acid, metformin, insulin glargine

P: Pancreatitis and type II diabetes

L: Yesterday evening

E: Possible haematemesis for 2 days, currently fasting for gastroscopy

SBAR

S: Mr de Jong is admitted to your ward for observation due to haematemesis for the past 2 days. He is about to undergo a gastroscopy and is therefore being kept fasting. Your colleague is asking you to go and check on him because he does not seem to be responding well.

B: Mr de Jong is 68 years old and has a history of pancreatitis and type II diabetes.

A: See ABCDE

R: Please assess the patient using ABCDE and apply interventions where necessary.

Situation at the start of scenario

A: Clear, responsive to voice.

B: RR 11 breaths/min, normal depth, symmetrical thoracic excursions, normal jugular veins, normal breath sounds, saturation 91%.

C: Normal colour, CRT 2 sec, HR 105 bpm, strong regular pulse, skin lukewarm and clammy, BP 141/82.

D: Voice on AVPU, glucose 1.2, pupils PEARL.

E: Temp 36.9°C, no oedema. Urine output: spontaneous 300 ml 3 hours ago.

Situation at the end of scenario

A: Clear, responsive to pain stimulus.

B: RR 10 breaths/min, normal depth, symmetrical thoracic excursions, normal jugular veins, normal breath sounds, saturation 86%.

C: Greyish colour, CRT 2 sec, HR 104 bpm, strong regular pulse, skin lukewarm and clammy, BP 132/80.

D: Pain on AVPU, glucose 1.0, pupils PEARL.

E: Temp 36.9°C, no oedema.

Recommendations

  • Recheck blood glucose