The patient had a blood sugar reading of 201. I received a quality assurance notice claiming our guidelines require IV fluids for any glucose level over 200. The sender cited MU protocols as the source. I’m standing my ground on this one. No matter how many times I handle this scenario, that patient is going straight to triage without an IV, protocol or not.
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Only if they show signs of dehydration.
I would ask to actually read that protocol because it sounds like nonsense. Elevated glucose can be caused by numerous factors. We see stress-induced hyperglycemia in almost every condition we treat, from trauma and strokes to heart attacks and sepsis. If this guideline is meant for suspected DKA, the patient should meet other benchmarks first, such as rapid breathing, high heart rate, or a history of Type 1 diabetes.
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That specific protocol definitely requires a second look.
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