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Treating Hypoglycemia " Rule of 50"

Updated: Feb 9, 2023

A quick memory aid 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. To make D25% from an ampule of D50%, you discard 25 ml out of one ampule of D50, then draw 25 ml of NS or sterile water into the D50 amp. To make D10% from an ampule of D50%, discard 40ml out of one ampule of D50, then draw 40ml of NS or sterile water into the D50 amp. Agitate the syringe to mix the solution. Inpatient and ED settings may readily have D25% or D10% solutions.

In general low glucose is < 60mg/dl or <40mg/dl in neonates. If the child is awake, alert, and appropriate, then give oral glucose (juice, ice cream, cake frosting, or breast milk/formula for neonates)

Disclaimer: This post is for educational purposes and is not intended as medical advice. While we strive for 100% accuracy, errors may occur, and medications or protocols may change over time.



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