Hypoglycaemia

Goals

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

Anamnese

• Name: Mr de Lange
• Age: 67 years
• Family: Married
• Occupation: Carpenter
• Cultural: Not known

AMPLE

• A.Unknown
• M.Aspirin, metformin, gliclazide, insulin glargine
• P.Renal impairment, myocardial infarction, type II diabetes
• L.Last night
• E.Abdominal complaints for 3 days, now fasting for abdominal ultrasound

SBAR

• S.Mr de Lange is admitted to your ward for observation of abdominal complaints. He is being kept fasting for a planned abdominal ultrasound. Your colleague is now asking you to check on him because he does not appear to be responding normally.
• B.Mr de Lange is 67 years old and has a history of renal impairment, myocardial infarction 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.Compromised airway, snoring breathing.
• B.RR 12 breaths/min, normal depth, symmetrical thoracic excursions, normal jugular veins, normal breath sounds, saturation 89%.
• C.Normal colour, CRT 2 sec, HR 105 bpm, strong regular pulse, skin lukewarm and clammy, BP 145/80.
• D.Voice on AVPU, glucose 1.1, pupils PEARL.
• E.Temp 36.9°C, no oedema. Urine output: spontaneous 200 ml 3 hours ago.

Situation at the end of scenario

• A.Compromised airway, snoring breathing.
• B.RR 12 breaths/min, normal depth, symmetrical thoracic excursions, normal jugular veins, normal breath sounds, saturation 85%.
• C.Ashen colour, CRT 2 sec, HR 91 bpm, strong regular pulse, skin lukewarm and clammy, BP 132/80.
• D.Pain on AVPU, glucose 1.0, pupils PEARL.
• E.Temp 36.4°C, no oedema.

Recommendations

• Recheck glucose level