Question:
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.
Answer:
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.)
DO'B
Original posting 26 Jul 97
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