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	<id>https://www.crsguidelines.org/index.php?action=history&amp;feed=atom&amp;title=4-2_PEDIATRIC_ALTERED_MENTAL_STATUS-HYPOGLYCEMIA</id>
	<title>4-2 PEDIATRIC ALTERED MENTAL STATUS-HYPOGLYCEMIA - Revision history</title>
	<link rel="self" type="application/atom+xml" href="https://www.crsguidelines.org/index.php?action=history&amp;feed=atom&amp;title=4-2_PEDIATRIC_ALTERED_MENTAL_STATUS-HYPOGLYCEMIA"/>
	<link rel="alternate" type="text/html" href="https://www.crsguidelines.org/index.php?title=4-2_PEDIATRIC_ALTERED_MENTAL_STATUS-HYPOGLYCEMIA&amp;action=history"/>
	<updated>2026-04-20T14:21:14Z</updated>
	<subtitle>Revision history for this page on the wiki</subtitle>
	<generator>MediaWiki 1.37.2</generator>
	<entry>
		<id>https://www.crsguidelines.org/index.php?title=4-2_PEDIATRIC_ALTERED_MENTAL_STATUS-HYPOGLYCEMIA&amp;diff=149&amp;oldid=prev</id>
		<title>Cgabryszek at 14:53, 30 April 2024</title>
		<link rel="alternate" type="text/html" href="https://www.crsguidelines.org/index.php?title=4-2_PEDIATRIC_ALTERED_MENTAL_STATUS-HYPOGLYCEMIA&amp;diff=149&amp;oldid=prev"/>
		<updated>2024-04-30T14:53:23Z</updated>

		<summary type="html">&lt;p&gt;&lt;/p&gt;
&lt;table style=&quot;background-color: #fff; color: #202122;&quot; data-mw=&quot;interface&quot;&gt;
				&lt;col class=&quot;diff-marker&quot; /&gt;
				&lt;col class=&quot;diff-content&quot; /&gt;
				&lt;col class=&quot;diff-marker&quot; /&gt;
				&lt;col class=&quot;diff-content&quot; /&gt;
				&lt;tr class=&quot;diff-title&quot; lang=&quot;en&quot;&gt;
				&lt;td colspan=&quot;2&quot; style=&quot;background-color: #fff; color: #202122; text-align: center;&quot;&gt;← Older revision&lt;/td&gt;
				&lt;td colspan=&quot;2&quot; style=&quot;background-color: #fff; color: #202122; text-align: center;&quot;&gt;Revision as of 09:53, 30 April 2024&lt;/td&gt;
				&lt;/tr&gt;&lt;tr&gt;&lt;td colspan=&quot;2&quot; class=&quot;diff-lineno&quot; id=&quot;mw-diff-left-l29&quot;&gt;Line 29:&lt;/td&gt;
&lt;td colspan=&quot;2&quot; class=&quot;diff-lineno&quot;&gt;Line 29:&lt;/td&gt;&lt;/tr&gt;
&lt;tr&gt;&lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;&lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;# Consider need for vascular access and administer NS at a TKO rate if indicated. If IV access unlikely or cannot be obtained in 2 attempts in a child less than 6 do not attempt further IV placement.&lt;/div&gt;&lt;/td&gt;&lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;&lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;# Consider need for vascular access and administer NS at a TKO rate if indicated. If IV access unlikely or cannot be obtained in 2 attempts in a child less than 6 do not attempt further IV placement.&lt;/div&gt;&lt;/td&gt;&lt;/tr&gt;
&lt;tr&gt;&lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;&lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;# If vascular access obtained, recheck blood glucose and if less than 60, administer Dextrose according to the following:&lt;/div&gt;&lt;/td&gt;&lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;&lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;# If vascular access obtained, recheck blood glucose and if less than 60, administer Dextrose according to the following:&lt;/div&gt;&lt;/td&gt;&lt;/tr&gt;
&lt;tr&gt;&lt;td class=&quot;diff-marker&quot; data-marker=&quot;−&quot;&gt;&lt;/td&gt;&lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;## &lt;del style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;Age older than 2 administer D&amp;lt;sub&amp;gt;50&amp;lt;/sub&amp;gt;W at 1.0mL&lt;/del&gt;/kg &lt;del style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;IV&lt;/del&gt;&lt;/div&gt;&lt;/td&gt;&lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;&lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;##&lt;ins style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;Administer 5mL&lt;/ins&gt;/kg &lt;ins style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;of D10 up to 125mL&lt;/ins&gt;&lt;/div&gt;&lt;/td&gt;&lt;/tr&gt;
&lt;tr&gt;&lt;td class=&quot;diff-marker&quot; data-marker=&quot;−&quot;&gt;&lt;/td&gt;&lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;## &lt;del style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;Age over 3 months and under 2 years administer D&amp;lt;sub&amp;gt;25&amp;lt;/sub&amp;gt;W at 1.0mL/kg IV&lt;/del&gt;&lt;/div&gt;&lt;/td&gt;&lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;&lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;##&lt;ins style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;# This dose is for all ages (newborn - adult size)&lt;/ins&gt;&lt;/div&gt;&lt;/td&gt;&lt;/tr&gt;
&lt;tr&gt;&lt;td class=&quot;diff-marker&quot; data-marker=&quot;−&quot;&gt;&lt;/td&gt;&lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;## &lt;del style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;Age under 3 months administer D&amp;lt;sub&amp;gt;12.5&lt;/del&gt;&amp;lt;&lt;del style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;/sub&amp;gt;W at 1&lt;/del&gt;.&lt;del style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;0mL/kg IV&lt;/del&gt;&lt;/div&gt;&lt;/td&gt;&lt;td class=&quot;diff-marker&quot; data-marker=&quot;+&quot;&gt;&lt;/td&gt;&lt;td style=&quot;color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;##&lt;ins style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;# If blood glucose remains &lt;/ins&gt;&amp;lt;&lt;ins style=&quot;font-weight: bold; text-decoration: none;&quot;&gt;60, a repeat does may be administered&lt;/ins&gt;.&lt;/div&gt;&lt;/td&gt;&lt;/tr&gt;
&lt;tr&gt;&lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;&lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;## If vascular access unavailable, consider glucagon administration as above.&lt;/div&gt;&lt;/td&gt;&lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;&lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;## If vascular access unavailable, consider glucagon administration as above.&lt;/div&gt;&lt;/td&gt;&lt;/tr&gt;
&lt;tr&gt;&lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;&lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;# &amp;#039;&amp;#039;&amp;#039;Contact MEDICAL CONTROL&amp;#039;&amp;#039;&amp;#039; &amp;#039;&amp;#039;&amp;#039;to request ALS intercept&amp;#039;&amp;#039;&amp;#039; and for orders regarding rate of fluid administration or further medication order, including consideration for administration of &amp;#039;&amp;#039;&amp;#039;naloxone (Narcan),&amp;#039;&amp;#039;&amp;#039; 0.1 mg/kg (max dose 2 mg total).&lt;/div&gt;&lt;/td&gt;&lt;td class=&quot;diff-marker&quot;&gt;&lt;/td&gt;&lt;td style=&quot;background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;&quot;&gt;&lt;div&gt;# &amp;#039;&amp;#039;&amp;#039;Contact MEDICAL CONTROL&amp;#039;&amp;#039;&amp;#039; &amp;#039;&amp;#039;&amp;#039;to request ALS intercept&amp;#039;&amp;#039;&amp;#039; and for orders regarding rate of fluid administration or further medication order, including consideration for administration of &amp;#039;&amp;#039;&amp;#039;naloxone (Narcan),&amp;#039;&amp;#039;&amp;#039; 0.1 mg/kg (max dose 2 mg total).&lt;/div&gt;&lt;/td&gt;&lt;/tr&gt;
&lt;/table&gt;</summary>
		<author><name>Cgabryszek</name></author>
	</entry>
	<entry>
		<id>https://www.crsguidelines.org/index.php?title=4-2_PEDIATRIC_ALTERED_MENTAL_STATUS-HYPOGLYCEMIA&amp;diff=76&amp;oldid=prev</id>
		<title>Cgabryszek: Created page with &quot;{| class=&quot;wikitable&quot; |&#039;&#039;&#039;EMR - Emergency Medical Responder&#039;&#039;&#039; |}  # Establish patient responsiveness. If cervical spine trauma is suspected, manually stabilize the spine. # Assess the patient’s airway of patency, protective reflexes and the possible need for advanced airway management. Look for signs of airway obstruction and if present proceed as per airway obstruction protocol. # Open the airway via chin lift or modified jaw thrust. # Suction as necessary # Consider...&quot;</title>
		<link rel="alternate" type="text/html" href="https://www.crsguidelines.org/index.php?title=4-2_PEDIATRIC_ALTERED_MENTAL_STATUS-HYPOGLYCEMIA&amp;diff=76&amp;oldid=prev"/>
		<updated>2022-04-04T01:58:44Z</updated>

		<summary type="html">&lt;p&gt;Created page with &amp;quot;{| class=&amp;quot;wikitable&amp;quot; |&amp;#039;&amp;#039;&amp;#039;EMR - Emergency Medical Responder&amp;#039;&amp;#039;&amp;#039; |}  # Establish patient responsiveness. If cervical spine trauma is suspected, manually stabilize the spine. # Assess the patient’s airway of patency, protective reflexes and the possible need for advanced airway management. Look for signs of airway obstruction and if present proceed as per airway obstruction protocol. # Open the airway via chin lift or modified jaw thrust. # Suction as necessary # Consider...&amp;quot;&lt;/p&gt;
&lt;p&gt;&lt;b&gt;New page&lt;/b&gt;&lt;/p&gt;&lt;div&gt;{| class=&amp;quot;wikitable&amp;quot;&lt;br /&gt;
|&amp;#039;&amp;#039;&amp;#039;EMR - Emergency Medical Responder&amp;#039;&amp;#039;&amp;#039;&lt;br /&gt;
|}&lt;br /&gt;
&lt;br /&gt;
# Establish patient responsiveness. If cervical spine trauma is suspected, manually stabilize the spine.&lt;br /&gt;
# Assess the patient’s airway of patency, protective reflexes and the possible need for advanced airway management. Look for signs of airway obstruction and if present proceed as per airway obstruction protocol.&lt;br /&gt;
# Open the airway via chin lift or modified jaw thrust.&lt;br /&gt;
# Suction as necessary&lt;br /&gt;
# Consider placing an oropharyngeal or nasopharyngeal airway adjunct if the airway cannot be maintained with positioning and the patient is unconscious.&lt;br /&gt;
# Assess patient breathing, including mental status rate, auscultation, inspection, respiratory effort, adequacy of ventilation as indicated by chest rise and obtain a pulse oximetry reading.&lt;br /&gt;
# If signs of respiratory arrest or respiratory failure with inadequate breathing are present, assist ventilation using a B-V-M device with 100% oxygen.&lt;br /&gt;
# If breathing is adequate, place the child in a position of comfort and administer high-flow 100% oxygen as tolerated.&lt;br /&gt;
# Assess circulation and perfusion.&lt;br /&gt;
# &amp;#039;&amp;#039;&amp;#039;Call for ALS intercept&amp;#039;&amp;#039;&amp;#039; &lt;br /&gt;
&lt;br /&gt;
{| class=&amp;quot;wikitable&amp;quot;&lt;br /&gt;
|&amp;#039;&amp;#039;&amp;#039;EMT - Emergency Medical Technician&amp;#039;&amp;#039;&amp;#039;  &amp;#039;&amp;#039;Perform/Confirm All Above Interventions&amp;#039;&amp;#039;&lt;br /&gt;
|}&lt;br /&gt;
&lt;br /&gt;
# Assess patient breathing, including mental status, rate, auscultation, inspection, respiratory effort, adequacy of ventilation as indicated by chest rise and obtain a pulse oximetry reading.&lt;br /&gt;
# Check blood glucose and if less than 60 mg/dL, administer &amp;#039;&amp;#039;&amp;#039;Glucagon&amp;#039;&amp;#039;&amp;#039; 0.1 mg/kg IM (Max dose 1 mg if weight &amp;gt;20kg and 0.5 mg if weight &amp;lt; 20 kg).&lt;br /&gt;
# Initiate transport and &amp;#039;&amp;#039;&amp;#039;Contact MEDICAL CONTROL&amp;#039;&amp;#039;&amp;#039; to request ALS intercept.&lt;br /&gt;
&lt;br /&gt;
{| class=&amp;quot;wikitable&amp;quot;&lt;br /&gt;
|&amp;#039;&amp;#039;&amp;#039;AEMT – Advanced Emergency Medicine Tech  &amp;#039;&amp;#039;&amp;#039; &amp;#039;&amp;#039;Perform/Confirm All Above Interventions&amp;#039;&amp;#039;&lt;br /&gt;
|}&lt;br /&gt;
&lt;br /&gt;
# Assess patient breathing, including rate, auscultation, inspection, respiratory effort, adequacy of ventilation as indicated by chest rise and obtain a pulse oximetry reading.&lt;br /&gt;
# Consider need for vascular access and administer NS at a TKO rate if indicated. If IV access unlikely or cannot be obtained in 2 attempts in a child less than 6 do not attempt further IV placement.&lt;br /&gt;
# If vascular access obtained, recheck blood glucose and if less than 60, administer Dextrose according to the following:&lt;br /&gt;
## Age older than 2 administer D&amp;lt;sub&amp;gt;50&amp;lt;/sub&amp;gt;W at 1.0mL/kg IV&lt;br /&gt;
## Age over 3 months and under 2 years administer D&amp;lt;sub&amp;gt;25&amp;lt;/sub&amp;gt;W at 1.0mL/kg IV&lt;br /&gt;
## Age under 3 months administer D&amp;lt;sub&amp;gt;12.5&amp;lt;/sub&amp;gt;W at 1.0mL/kg IV&lt;br /&gt;
## If vascular access unavailable, consider glucagon administration as above.&lt;br /&gt;
# &amp;#039;&amp;#039;&amp;#039;Contact MEDICAL CONTROL&amp;#039;&amp;#039;&amp;#039; &amp;#039;&amp;#039;&amp;#039;to request ALS intercept&amp;#039;&amp;#039;&amp;#039; and for orders regarding rate of fluid administration or further medication order, including consideration for administration of &amp;#039;&amp;#039;&amp;#039;naloxone (Narcan),&amp;#039;&amp;#039;&amp;#039; 0.1 mg/kg (max dose 2 mg total).&lt;br /&gt;
&lt;br /&gt;
{| class=&amp;quot;wikitable&amp;quot;&lt;br /&gt;
|&amp;#039;&amp;#039;&amp;#039;Intermediate -&amp;#039;&amp;#039;&amp;#039; &amp;#039;&amp;#039;Perform/Confirm All Above Interventions&amp;#039;&amp;#039;&lt;br /&gt;
|}&lt;br /&gt;
&lt;br /&gt;
# Consider alternate causes of altered mental status, including dehydration, head trauma, seizures and drug intoxication and treat appropriately.&lt;br /&gt;
# Evaluate for need for endotracheal intubation.&lt;br /&gt;
# Initiate transport.&lt;br /&gt;
# &amp;#039;&amp;#039;&amp;#039;Contact MEDICAL CONTROL&amp;#039;&amp;#039;&amp;#039; for further orders.&lt;br /&gt;
&lt;br /&gt;
{| class=&amp;quot;wikitable&amp;quot;&lt;br /&gt;
|&amp;#039;&amp;#039;&amp;#039;Paramedic -&amp;#039;&amp;#039;&amp;#039; &amp;#039;&amp;#039;Perform/Confirm All Above Interventions&amp;#039;&amp;#039;&lt;br /&gt;
|}&lt;/div&gt;</summary>
		<author><name>Cgabryszek</name></author>
	</entry>
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