How to manage hypoglycaemia in NYI

Learning objectives

After completion of this session the participant should be able to:

Define hypoglycaemia
Describe the treatment of hypoglycaemia in a symptomatic and asymptomatic NYI

Hypoglycaemia is common in LBW and very sick NYI and should always be considered early in the management. 20% of infants < 7 days have hypoglycaemia. And there is an increased association with mortality, convulsions and permanent brain injury.

COIN defines hypoglycaemia as < 45mg per dl (2.5 mmol/L) for NYI.

Chart A: Identify a NYI with hypoglycaemia

Chart B: Management of a baby with blood glucose of less than < 45 mg/dl (2.5 mmol/l) and NOT symptomatic

Chart C: Management of a baby with blood glucose of less than < 45 mg/dl (2.5 mmol/l) and symptomatic

How to make up a 10% dextrose solution when you only have 50% dextrose

	Water for Injection or Ringers Lactate or Normal Saline	50% Dextrose
	4 parts	1 part
5 ml syringe	4mls	1ml
10 ml syringe	8mls	2ml
20 ml syringe	16mls	4mls
50 ml syringe	40mls	10mls
100 ml burette	80mls	20mls
200 ml bag	160mls	<40mls

To make up a bag of fluids - empty fluid out of a litre bag of fluids until there is only 200mls left (4 parts) and then add 50mls of 50% dextrose (1 part) to make up 250mls of a 10% dextrose solution.

	Water for Injection or Ringers Lactate or Normal Saline	50% Dextrose
250mls in a litre bag	200mls	50mls