Hypoglycemia

What Is Hypoglycemia?

Hypoglycemia is an acute medical emergency characterized by a blood glucose concentration below 70 mg/dL (severe under 50 mg/dL), presenting with altered mental status, diaphoresis, tachycardia, tremors, and stroke-like focal neurological deficits.

Why Hypoglycemia Matters on the Fireground

Brain cells rely almost exclusively on glucose for metabolism. Severe hypoglycemia causes rapid loss of consciousness, seizures, brain damage, and death if untreated. Paramedics can reverse hypoglycemia in minutes using Dextrose IV or Glucagon IM, restoring full consciousness on scene.

Relevant NFPA Standards

• NREMT Standards: National Registry of Emergency Medical Technicians Practice Standards
• NFPA 455: Standard for Emergency Medical Services (EMS)

Field Procedures & Tactical Steps

1. Assess primary airway/breathing and obtain capillary blood glucose sample via fingerstick glucometer.
2. If glucose is <70 mg/dL and patient is conscious with intact gag reflex: administer 15–30g of oral glucose gel.
3. If patient is unresponsive or unable to swallow: establish IV access and administer 10% Dextrose (D10W 100–250 mL IV bag) or 50% Dextrose (D50W 25g IV push).
4. If IV access cannot be obtained: administer Glucagon 1 mg IM/IN.
5. Recheck blood glucose after 5–10 minutes and monitor for return of baseline mental status.

Common Context & Application

Encountered on EMS calls for altered mental status, unresponsive patients, diabetic emergencies, seizures, and suspected stroke.

Frequently Asked Questions about Hypoglycemia