Non-neonatal hypoglycemia (peds)

Differential Diagnosis

1. Ingestions (e.g. ETOH)
2. Metabolic disease^
3. Sepsis

^Save blood tubes before treatment

Treatment

• Glucose
  • Bolus D10W 2mL/kg; then infuse D10W @ 0.06-0.08mL/kg/min
• Glucagon
  • Used for persistent hypoglycemia despite glucose administration
  • 0.03 mg/kg subq/IV

Pediatric Hypoglycemia Dextrose Chart

Category	Age	Glucose	Treatment	Initial IV Bolus	Maintenance Dose
Neonatal	<2mo	<40	D10W	2.5-5 mL/kg	6 mL/kg/h
Pediatric	2mo-8yrs	<60	D25W	2 mL/kg	D10W: 6 mL/kg/h for first 10 kg + 3 mL/kg/h for 11–20 kg + 1.5 mL/kg/h for each additional kg >20 kg
Adult	>8yrs	<70	D50W	50mL (1 amp) OR 1 mL/kg

• Consider diluting the D25W or D50W bolus, with NS 1-to-1, as those concentrations may be sclerosing to veins
• Recheck 5 minutes after dose and repeat dose if low.
• Consider glucagon IM/SQ if IV access is not readily available

See Also

Hypoglycemia (Neonatal)

Hypoglycemia