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Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by methodical review of available evidence and consensus among committee members.

The Hyperglycemic Hyperosmolar Syndrome (HHS) synopsis provides a high-level overview of the care standards employed for this Clinical Pathway. 

Algorithms associated with this Clinical Pathway: 

Inclusion criteria: 

  • Severe hypoglycemia (glucose > 500)
  • Effective serum osmolality > 350
  • Serum bicarbonate > 16 mmol/L

Committee members involved in the development: 

  • M. Knoll, MD, MHPE | Endocrinology | Committee chair
  • R. McDonough, DO | Endocrinology | Committee member
  • A. Stoner, MS, DO | Critical Care Medicine | Committee member
  • S. Fagan, RN, BSN, CCRN-K | Pediatric Intensive Care Unit | Committee member

MIT Committee Members:

  • T. Frank, RPh, CPHIMS | Medical Informatics - Pharmacy | Committee member

EBP Committee Members:

  • K. Berg, MD, FAAP | Hospitalist, Evidence Based Practice
  • J. Bartlett, PhD, RN | Evidence Based Practice
  • Megan Gripka, MT (ASCP) SM | Evidence Based Practice
  • Kelli Reiling Ott, OTD, OTR/L | Evidence Based Practice

Publication dates: 

  • Finalized date: 12/2022 
  • Next expected revision date: 12/2025

Concerns with content:

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These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.