Hypoglycaemia

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