Question: Whilst completing my pre-course recertification material, we were asked a question with regards to blood glucose testing. Following administration of med for hypoglycemia, the question asked when next should you do a blood glucose test. I had guessed after 5 min although re-dosing would not be for 10 or 20 min depending on drug used. I guessed wrong apparently. The other choices would have been: a) With EVERY vitals post treatment (what about a long off load, we might do 3 or 4 more sets of vitals!) b) After no improvement (no time noted and they might not show no improvement for a few minutes and sticking them after just two would be unnecessary) c) Once at the hospital (that would disallow the re-administration of a second dose of treatment.)
In order for a medication to work, a certain amount of time is required for the drug to be absorbed and metabolized. If a patient is found to be hypoglycemic and treatment is administered as per the hypoglycemia directive, glucose should be rechecked if the patient's symptoms are not improving. Based on the pharmacokinetics of dextrose and glucagon, a second treatment cannot be provided until 10 minutes after dextrose is administered or 20 minutes after glucagon is administered as it can take this amount of time for these medications to increase the glucose to appropriate levels. It is advised to recheck the glucose at these times. It is not recommended that glucose be rechecked at the hospital prior to handover, given that administered medication has not had time to reach its full effect and repeating the glucose would not change any paramedic management.