managing hypoglycemia & hyperglycemia critical care
DESCRIPTION
Hypoglycemia and Hyperglycemia in the critical care patientTRANSCRIPT
- 1. Managing Hypoglycemia & Hyperglycemia
Critical Care Adult Patients
2. HYPOGLYCEMIA
HYPERGLYCEMIA
Diabetes
Medication Adverse Effects
Medication Interactions
Continuous Renal Replacement Therapy
Sepsis
Nutrition Imbalance
Diabetes
Medication Adverse Effects
Medication Interactions
Sepsis
Stress Induced
Nutrition Imbalance
RISK FACTORS
3. Effective glucose control in the intensive care unit (ICU) has
been shown to decrease morbidity across a large range of conditions
and also to decrease mortality (IHI,2009).
4. TIGHT GLYCEMIC CONTROL IN CRITCALLY ILL ADULTS
Target range is 80-110
Hyperglycemic patients are started on a Regular Insulin drip
titrated depending on blood glucose levels.
Blood glucose levels are check every hour
Each institution has a protocol with guidelines for titration
5. Managing Hypoglycemia
Blood glucose less than 70 or per hospital policy/protocol
First assess the patient to see if they exhibit symptoms ex: change
in mental status, irritability.
Medication usually given are:
1. Orange juice orally followed by a snack
2. Glucagon IM or IV
3. Dextrose 50% IV (most common in ICU)
6. Managing Hyperglycemia
PRN sliding scale with fast acting Regular or Aspart insulin is
used mostly for DiabeticsEx. If blood glucose 200-249 Give 2 units
Regular insulin SQ
Longer acting insulin (NPH, Levemir, Lantus) is usually
administered daily
For tight glycemic control or critically abnormal high (>400)
glucose levels, continuous Regular insulin IV is given
7. REVIEW
Hypoglycemia is a priority issue and is mostly managed with D50
IV
Hyperglycemia is equally important and is managed with
insulin.
Only regular insulin is administered IV
Its important to monitor blood glucose levels as well as assess the
patient.