MyCpdZw - Protocols Details

HYPOGLYCAEMIA

Hypoglycemia occurs when blood glucose levels fall below 4 mmol/L (72mg/dL). ... Hypoglycemia occurs when the level of glucose present in the blood falls below a set point.

Diagnosis

Don’t have to be diabetic ( septic, alcohol, hepatic & renal failure & insulinomas) but common in

Type 1 IDDM.

Commonest cause of diabetic coma.

In diabetics caused by inadequate oral intake, excess insulin/oral hypoglycaemic, exercise or

alcohol.

Symptoms variable: Pale, altered mental function (confusion, aggression, seizures, coma, focal

deficits), sweaty, tachycardia, tremor.

Management

1. Bedside BSL <3 mmol/1

2. Oral glucose followed by long acting carbohydrates (sandwich or fruit) if conscious

3. Glucagon 1mg IM if poor venous access or any delay to treatment expected

4. IV 50% Dextrose 25mls bolus (2ml/kg 10% in children)

5. Response should be rapidly evident within 3-4 minutes otherwise repeat IV glucose or consider other causes,

6. Following prolonged hypoglycaemia recovery may be more protracted despite

restoration of Blood Sugar Levels

7. Hypoglycaemia secondary to oral hypoglycaemic agents may be recurrent & will require IV 5% Dextrose & admission,

Consider Octerotide 50 mcg SC 8 hourly for 3 doses (inhibitor of pancreatic insulin release)

Recent Protocols

COVID 19

COVID 19 is a disease caused by the most recently discovered coronavirus which is a large family of corona viruses causing illnesses. In humans it causes Respiratory infections for example Severe Acute Respiratory Disease (SARs) PRESENTATION Fever 77-98% Cough 46-82% Myalgia/Fatigue 11-52% Shortness of breath 3-31% Incubation period 14 days, most people develop symptoms between 5-6ays from exposure Stage1 (Early infection). Stage 2. Stage 3(Hyperinflation phase) Viral response---------------------------Pulmonary Phase----------------------Host Response *Anyone presenting with flu like symptoms should be assumed to be a COVID 19 case until proven otherwise*

WARFARIN OVERDOSE/ TOXICITY

Overdose of the oral anticoagulant warfarin (Coumadin), or drug interactions with warfarin, can lead to toxicity. Similarly, toxicity can result from exposure to superwarfarins, which are long-acting anticoagulants used in rodenticides. ... Warfarin is the most common oral anticoagulant in current use

SUICIDAL IDEATION

Suicidal ideation, also known as suicidal thoughts, is thinking about or having an unusual preoccupation with suicide.

SPINAL CORD INJURY

Emergency signs and symptoms of a spinal cord injury after an accident may include: Extreme back pain or pressure in your neck, head or back. Weakness, incoordination or paralysis in any part of your body. Numbness, tingling or loss of sensation in your hands, fingers, feet or toes. Loss of bladder or bowel control.