Prehospital

5/2/1 – 50! Dextrose volume for hypoglycemia

EMKF

There is a quick memory aid that will help you remember how much dextrose to give to patients with hypoglycemia. It is commonly known as the 5/2/1 rule, or the rule of 50.

D10 5 mL/kg

D25 2 mL/kg

D50 1 mL/kg

Note that all three, when multiplied, equal 50 (e.g. 5ml/kg x 10 = 50)

Given the hypertonicity of D50 it can be dangerous to give through a peripheral IV. It can cause phlebitis and thrombosis and in pediatric patients it is rarely indicated, especially when D10 or D25 (in bigger kids) will work just as well.

C-Spine immobilization with C-Collars is a waste of time, harmful and expensive…

EMKF

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  • Myth: Additional movement of the spine in a patient with a spinal injury would actually worsen the condition or result in a secondary injury. There are really no data to support this.
  • The natural responses of the body to a serious injury actually provide somewhat of a de facto splint. With C-spine injuries, the muscles of the neck contract and that, along with pain, limits additional severe motion (at least in a conscious patient)
  • There’s absolutely NO EVIDENCE the C-spine can be immobilized to any significant degree.
  • C-collars interfere with airway management
  • C-collars cause pressure sores