QUESTION: What is the best and most appropriate way to administer D10W?
Answer: Great question! There are actually a couple ways of doing so. Keep in mind that administering D10W to hypoglycemic patients is new to the majority of Paramedics in SWORBHP region; and that the appropriate dose is 0.2 g/kg (2 ml/kg) to a maximum of 25 g (250 ml). *updated for ALS-PCS 4.9 Feb 1, 2022
It’s likely that the D10W on your trucks is supplied in a 250ml bag (or similar), which means that you have far too much medication available in that one bag and are required to measure out the appropriate volume in order to administer the appropriate dose.
So, how do you measure out the appropriate volume?
CASE: Your hypoglycemic pediatric patient weighs 40 kg – the required dose is 8g and required volume is 80 ml.
Option 1: Set up an Inline Volumetric Cylinder (ie. Buretrol) to the bag of D10W and fill the chamber with 80 ml of fluid. Once filled with 80 ml, clamp above the chamber and run the line below. The inline Volumetric Cylinder prevents larger volumes of fluid inadvertently being infused.
Option 2: Use a large syringe to draw up 80 ml of D10W directly from the bag and administer via IV push (much like you would push D50W).
Note: SWORBHP does not support simply attaching the bag of D10W to an IV line and measuring volume administration via bag markers. One of the above two options must be used.
When selecting your option for administration, use clinical judgment and decide based on ease of use, safety, available equipment and timely medication delivery. Ensure you go through the RIGHTS of medication administration and perform an independent double check with your partner. The most important step is safety – safety of the appropriate dose, route, method, etc.