FIELD REFERENCE
Full criteria & treatment guidance
Indications
- Symptomatic/suspected hypoglycemia under PR-085 and the applicable adult/pediatric order.
Contraindications & local exclusions
- The verified Baxter 10% IV dextrose reference label excludes clinically significant hyperglycemia and known hypersensitivity to dextrose. This label also covers 5%, but this page’s reference formulation is 10% (100 mg/mL). D25/D50 or concentrated parenteral-nutrition exclusions are not transferred. OCEMS PR-085 establishes the separate hypoglycemia pathway and permitted IV/IO use; the product label itself describes IV infusion, not IO authorization.
Precautions
- Confirm D10 concentration and patent access; titrate and reassess glucose and mental status under PR-085. The Baxter label warns of hyperglycemia, hypersensitivity, phlebitis/thrombosis, hyponatremia, fluid/electrolyte imbalance and particular neonatal/pediatric glucose risks. Do not administer simultaneously with blood products through the same set. Its labeled use as water/calories or a diluent does not establish OCEMS hypoglycemia dosing authority.
- These are selected safety checks, not a complete prescribing monograph. Product labeling and OCEMS authorization answer different questions; confirm the actual product, patient population and applicable order.
Check before giving
- D10 is 10% dextrose; do not substitute a different concentration while retaining the same volume.
- The usual IO exception requires an unconscious patient, glucose below 60, inability to obtain IV access, and no response to IM glucagon. Check the exact condition order.
Use in OCEMS
- Used for symptomatic or suspected hypoglycemia in the applicable altered-mental-status, seizure, shock, and other condition-specific pathways.
- Adult PR-085 treats glucose at or below 60 mg/dL, and permits clinical judgment in the 60–80 range when hypoglycemia is suspected. Other standing orders use their own threshold wording.
Adult / adolescent
| Indication / route | Dose & limits |
|---|---|
| Hypoglycemia | D10 up to 250 mL IV, titrated to improve consciousness. Reduce to a keep-open rate when baseline mental status returns. |
Pediatric
- SO-P-065: glucose below 60 mg/dL → D10 5 mL/kg IV, maximum 250 mL. The seizure and overdose standing orders use different thresholds; follow the pathway that matches the presentation.
- PR-085 allows a measured IVPB dose or slow IV administration from a syringe. For IVPB, remove excess fluid so the bag contains only the intended pediatric dose.
Pediatric weight table — Hypoglycemia — D10
- SO-P-065 pediatric dose: 5 mL/kg IV.
- D10 (100 mg/mL): 5 mL/kg IV, maximum 250 mL. These values are fluid volumes of D10, not milligrams and not volumes of D50.
- For altered mental status, treat glucose below 60 mg/dL. Other pediatric standing orders have indication-specific thresholds.
- IO under SO-P-065 requires unconsciousness, glucose below 60, inability to establish IV, and no response to IM glucagon. Remove excess fluid from an IVPB bag so only the intended pediatric dose remains.
- Calculated examples for the exact weights shown, using the named standing-order/procedure formula. Do not round the patient’s weight to the nearest row. For another weight, calculate from the stated formula and apply the limits. These are not the rounded I-20 weight-band volumes.
| Exact weight | Dose — IV |
|---|---|
| 3 kg | 15 mL |
| 4 kg | 20 mL |
| 5 kg | 25 mL |
| 6 kg | 30 mL |
| 8 kg | 40 mL |
| 10 kg | 50 mL |
| 12 kg | 60 mL |
| 15 kg | 75 mL |
| 20 kg | 100 mL |
| 25 kg | 125 mL |
| 30 kg | 150 mL |
| 35 kg | 175 mL |
| 40 kg | 200 mL |
| 45 kg | 225 mL |
| 50 kg | 250 mL |
| 60 kg | 250 mL |
Preparation & reassessment
- Verify glucose, weight when pediatric, concentration, and intended milliliters.
- Follow PR-085 when giving other medications through the line; flush as directed. Document glucose, mental status, administered volume, and response.
UNDERSTAND THE CARE
Why concentration and volume must stay linked
D10 dosing instructions describe a particular concentration. Changing the solution while retaining its volume changes the amount of glucose delivered. Keep the product name, concentration, intended volume and route together during preparation. Glucose thresholds differ among the local condition orders, so use the one matching the presentation.
Applying the guidance
For a pediatric IVPB dose, the source instructs removing excess fluid so the bag contains the intended amount. The usual IO exception is narrower than simply having difficult IV access. Document the measured glucose, mental status, administered volume and response, and follow the line-flush instructions when other medications use the access.
Dose, concentration and volume
Diagram text & teaching checkpoints
- Clinical criteria
- Use the matching condition threshold.
- Product
- D10 concentration and intended volume.
- Route
- IV instructions or the explicit IO exception.
- Response
- Glucose-related findings and consciousness.
Sources for this explanation
Original OCMedic teaching synthesis of the references below. Educational expansion updated ; this is not a new independent clinical-review date. Source-specific dates and limitations remain in the full guidance.
- I-15 — Adult / Adolescent Standing Order Drug Guide
- I-20 — Pediatric Medication Volume Dose by Weight
- PR-085 — 10% Dextrose Solution Administration
- SO-M-020 — Altered Mental Status
- SO-P-065 — Altered Mental Status - Pediatric
- SO-P-075 — Seizure / Convulsion - Pediatric
- Reference D10 label — Baxter Dextrose Injection 5% and 10% — June 2026 labeling
A response-based D10 handoff
Treat the bag label, intended dose and volume actually delivered as three separate pieces of information. A bag that started with a particular volume does not prove that all of that volume reached the patient. PR-085 ties the infusion to the patient’s return toward baseline consciousness and describes changing to a keep-open rate when that endpoint is reached.
For example, if consciousness improves during transport, report the initial glucose and mental status, the amount delivered when improvement occurred, the current infusion status and the latest findings. If the infusion is completed, use the procedure’s saline-lock instructions. If another medication is needed through the access, use its specified port, interruption and flush process rather than assuming that an active D10 line is ready for any medication.
For a child, retain the calculated intended volume in the handoff as well as the volume administered. This makes a dose-limited IVPB distinguishable from a full stock bag and helps the receiving team understand what remains in the tubing or container.
Source: 10% Dextrose Solution Administration.