Question: I have noticed a number of paramedics do blood glucose testing based on the hx of an event and not how the patient is presenting at the time of assessment. For example - hx of fainting, period of unresponsiveness, diabetic with N/V, etc. If the patient is not presenting with any of the indicators outlined in the hypoglycemia protocol should we be testing the patients blood glucose levels?
This is a terrific question. The Base Hospital supports paramedics performing blood glucose testing in clinical situations where hypoglycemia could be the underlying or precipitating event. Classically, hypoglycemia is characterized by the clinical signs noted in the Indications section of the Hypoglycemia Medical Directive (agitation, altered LOA, seizure, symptoms of stroke).
Given the myriad of presentations of hypoglycemia, it is possible that a patient may be hypoglycemic and yet have other features (such as intense diaphoresis along with a sluggish behavior etc€¦).
To answer your question, given the above, the Base Hospital is supportive of paramedics performing blood glucose testing of patients when hypoglycemia is suspected in clinical situations beyond those solely described by the Medical Directive. Paramedics should utilize their critical decision making skills and document their rationale for performing this blood glucose sampling on the ACR.