Articles That May Change Your Practice: Dextrose Administration

Abstract

Paramedics typically administer high concentrations of dextrose to patients experiencing conditions such as hyperkalemia or hypoglycemia. The treatment typically involves the administration of 25 g highly concentrated (50%) dextrose. This dose may cause harm and lead to difficulties regulating posttreatment blood glucose levels. Peripheral administration of high concentrations of dextrose may be associated with phlebitis and extravasation injuries. Lower concentrations of dextrose, such as 10%, may be a safer alternative in preventing the adverse effects of boluses of 50% dextrose. In situations in which dextrose 50% in water (D50W) is not readily available, as has been the case during the pandemic due to severe acute respiratory syndrome coronavirus 2, there may be a need for safer alternatives. Russell D. MacDonald, MD, MPH, FCFP, FRCPC, is the former medical director at Ornge Transport Medicine; the current medical director at Toronto Paramedic Services; a professor in the Faculty of Medicine at the University of Toronto; and an attending staff member at Sunnybrook Health Sciences Centre in Toronto, Ontario, Canada. He can be reached at [email protected].