Ensure a patent airway.
Administer liquids that contain glucose.
If the patient is alert, give him juice with sugar added, followed by protein and complex carbohydrates to prevent hypoglycemia from recurring the next hour.
If the patient has a decreased level of consciousness, establish a large-bore I.V.line and administer 50 ml of 50% dextrose as a bolus. If he doesn’t regain consciousness in 15 minutes, repeat the bolus of dextrose.
If I.V. access can’t be established, administer glucose gel under the patient’s tongue or give glucose-rich liquids by nasogastric tube instead of providing the IM dextrose solution.
If none of the above interventions is possible, administer glucagon or epinephrine I.M.
Repeat the measurement of the blood glucose level in 1 hour.
Monitor the patient’s heart rate, cardiac rhythm and blood pressure.
Administer a normal saline bolus if hypotension occurs.
Replace electrolytes based on laboratory test results.
Help determine the cause of hypoglycemia by interviewing the patient and reviewing his history. Be sure to inquire about such common causes as poor food intake, medication changes, alcohol or other recreational drug use, hepatic or renal impairment that prevents gluconeogenesis, pancreatic tumor or an endocrine disorder, including impaired pituitary, thyroid, parathyroid, or adrenal glands.
Be aware that postprandial hypoglycemia may occur with many conditions, especially after gastric by pass surgery.