First Due Academy MedicalEMREMTAEMTParamedic

Diabetic Emergencies — Utah 2025 Protocol

Hypoglycemia is immediately life-threatening. Hyperglycemia is slower — prioritize airway and transport.

Steps by Cert Level

ALL: BGL check MANDATORY first. < 60 mg/dL = hypoglycemia. > 250 mg/dL = hyperglycemia.
EMT: Oral glucose (15–25g) if conscious and able to swallow and BGL < 60.
AEMT: IV/IO access. D10W 250mL IV or D50W 25g IV push for BGL < 60. Repeat BGL in 10 min.
PARAMEDIC: If no IV access: Glucagon 1mg IM. For hyperglycemia/DKA: NS 500mL–1L bolus. Monitor K+ — DKA causes profound hypokalemia after insulin.