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6. Parasitic diseases
– In oth er patients w ith H b < 7 g / d l, m onitor clinical status and H b lev el and consid er
transfusion on a case-by-case basis.
Hypoglycaemia
– If th e patient is able to sw allow :
5 0 m l of 1 0 % g lucose, or 4 0 m l of w ater + 1 0 m l of 5 0 % g lucose, or 5 0 m l of
w ater
+ 5 g (1 teaspoon) of g ranulated sug ar, or 5 0 m l of m ilk.
– ICn ahniludnrceonn:s5ciomusl/pakgtienotf:10% glucose by slow I V injection (5 m inutes) or infusion
7
A d ults: 1 m l/ kg of 50% glucose by slow I V injection (5 m inutes)
– C h eck blood g lucose lev el after 3 0 m inutes. I f blood g lucose lev el rem ains
< 3 m m ol/ l or < 5 5 m g / d l, ad m inister anoth er d ose or g iv e g lucose by oral route,
accord ing to th e patient‟s clinical cond ition. H ypog lycaem ia m ay recur: m aintain
reg ular sug ar intake (5 % g lucose, m ilk, accord ing to circum stances) and continue to
m onitor for sev eral h ours.
Notes:
– In an unconscious or prostrated patient, in case of em erg ency or w h en v enous access
hisyupnoagv layiclaabelme oriaa. w aited , use g ranulated sug ar by th e subling ual route to correct
8
– T h e risk of h ypog lycaem ia is h ig h er in patients receiv ing I V quinine.
Coma
C h eck/ en6sure th e airw ay is clear, m easure blood g lucose lev el and assess lev el
of
consciousness (B lantyre or G lasg ow com a scale).
In th e ev ent of h ypog lycaem ia or if blood g lucose lev el cannot be m easured , ad m inister
g lucose.
If th e patient d oes not respond to ad m inistration of g lucose, or if h ypog lycaem ia is not
d etected :
– E xclud e m ening itis (lum bar puncture) or proceed d irectly to ad m inistration of an
antibiotic (see Meningitis, pag e 1 6 5 ).
– Insert a urinary cath eter; place th e patient in th e recov ery position.
– R eposition th e patient ev ery 2 h ours; ensure eyes and m outh are kept clean and
m oist, etc.
– M onitor v ital sig ns, blood g lucose lev el, lev el of consciousness, urine output, h ourly
until stable, th en ev ery 4 h ours.
– M onitor fluid balance.
Seizures
See pag e 2 3 . A d d ress possible causes (e.g . h ypog lycaem ia; fev er in ch ild ren).
Respiratory distress
– R apid laboured breath ing :
C h eck for pulm onary oed em a, w h ich m ay occur w ith or w ith out fluid ov erload :
red uce I V infusion rate if th e patient is receiv ing I V th erapy, nurse sem i- sitting ,
oxyg en, furosemide IV : 1 m g / kg in ch ild ren, 4 0 m g in ad ults. R epeat after 1 to
2 h ours
Iinf ncehcildersesn,arify.ready-made G10% solution is not available: add 10 ml of G50% solution per 100 ml of G5%
A ssociated pneum onia sh ould also be consid ered (see Pneumonia, pag e 6 6 ).
Place a level teaspoon of sugar, moistened with a few drops of water, under the tongue, then place the patient in
7
solution to obtain a G10% solution.
8
the recovery position. Repeat after 15 min if the patient has not regained consciousness. As with other methods
for treating hypoglycaemia, maintain regular sugar intake, and monitor.
– In oth er patients w ith H b < 7 g / d l, m onitor clinical status and H b lev el and consid er
transfusion on a case-by-case basis.
Hypoglycaemia
– If th e patient is able to sw allow :
5 0 m l of 1 0 % g lucose, or 4 0 m l of w ater + 1 0 m l of 5 0 % g lucose, or 5 0 m l of
w ater
+ 5 g (1 teaspoon) of g ranulated sug ar, or 5 0 m l of m ilk.
– ICn ahniludnrceonn:s5ciomusl/pakgtienotf:10% glucose by slow I V injection (5 m inutes) or infusion
7
A d ults: 1 m l/ kg of 50% glucose by slow I V injection (5 m inutes)
– C h eck blood g lucose lev el after 3 0 m inutes. I f blood g lucose lev el rem ains
< 3 m m ol/ l or < 5 5 m g / d l, ad m inister anoth er d ose or g iv e g lucose by oral route,
accord ing to th e patient‟s clinical cond ition. H ypog lycaem ia m ay recur: m aintain
reg ular sug ar intake (5 % g lucose, m ilk, accord ing to circum stances) and continue to
m onitor for sev eral h ours.
Notes:
– In an unconscious or prostrated patient, in case of em erg ency or w h en v enous access
hisyupnoagv layiclaabelme oriaa. w aited , use g ranulated sug ar by th e subling ual route to correct
8
– T h e risk of h ypog lycaem ia is h ig h er in patients receiv ing I V quinine.
Coma
C h eck/ en6sure th e airw ay is clear, m easure blood g lucose lev el and assess lev el
of
consciousness (B lantyre or G lasg ow com a scale).
In th e ev ent of h ypog lycaem ia or if blood g lucose lev el cannot be m easured , ad m inister
g lucose.
If th e patient d oes not respond to ad m inistration of g lucose, or if h ypog lycaem ia is not
d etected :
– E xclud e m ening itis (lum bar puncture) or proceed d irectly to ad m inistration of an
antibiotic (see Meningitis, pag e 1 6 5 ).
– Insert a urinary cath eter; place th e patient in th e recov ery position.
– R eposition th e patient ev ery 2 h ours; ensure eyes and m outh are kept clean and
m oist, etc.
– M onitor v ital sig ns, blood g lucose lev el, lev el of consciousness, urine output, h ourly
until stable, th en ev ery 4 h ours.
– M onitor fluid balance.
Seizures
See pag e 2 3 . A d d ress possible causes (e.g . h ypog lycaem ia; fev er in ch ild ren).
Respiratory distress
– R apid laboured breath ing :
C h eck for pulm onary oed em a, w h ich m ay occur w ith or w ith out fluid ov erload :
red uce I V infusion rate if th e patient is receiv ing I V th erapy, nurse sem i- sitting ,
oxyg en, furosemide IV : 1 m g / kg in ch ild ren, 4 0 m g in ad ults. R epeat after 1 to
2 h ours
Iinf ncehcildersesn,arify.ready-made G10% solution is not available: add 10 ml of G50% solution per 100 ml of G5%
A ssociated pneum onia sh ould also be consid ered (see Pneumonia, pag e 6 6 ).
Place a level teaspoon of sugar, moistened with a few drops of water, under the tongue, then place the patient in
7
solution to obtain a G10% solution.
8
the recovery position. Repeat after 15 min if the patient has not regained consciousness. As with other methods
for treating hypoglycaemia, maintain regular sugar intake, and monitor.
