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From Montana, USA:

In an altered mental status patient who is unable to control their airway and is a diagnosed diabetic as well as hypoglycemic with no Glucagon available, and no IV access for D50, is rectal glucose of any value? I am asking as a Paramedic in an emergency situation only and it is a serious question.


Water, salts, glucose and many drugs can be absorbed through the rectal mucosa. In treating hypoglycemia, however, the problem is that if you give a sufficient volume and concentration of glucose solution by this route it is likely to draw water into the rectum and thus to act as an enema.

My suggestions would be to use either glucose tablets in the cheek pouch or a very viscous syrup or alternatively to get what pediatricians call 'butterfly' needles and to see if you can then access some of the small veins on the dorsum of the hands or feet or in the scalp. (Make sure that the needle is actually in the vein before you inject high concentration glucose.)


Original posting 26 Jul 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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