Do we really need to get a blood glucose on an actively seizing patient?
Thank you for this question. We understand that it can be challenging to obtain a finger-pick glucose on an actively seizing patient. However, since hypoglycemia is a rare but reversible cause of seizure, and prolonged seizure can cause irreversible neurologic damage, it is pertinent to check for treatable/reversible causes. According to the BLS v3.0.1 Seizure Standard: In situations involving a patient in seizure (or post-ictal), the paramedic shall:
1. Consider potential life/limb/functional threats and/or underlying disorders, such as€¦, b. hypoglycemia€¦ For the full list, please see BLS v3.0.1 pg 82.
As part of the provincial comprehensive medical directive review, SWORBHP has been assigned to review the seizure directive. We have proposed that changes be made to the directive that allow for paramedics to use clinical judgement to determine the cause of the seizure, thus guiding treatment decisions. Although obtaining a blood glucose will still be required, the priority at which it occurs has been proposed to be at the discretion of the treating paramedic. Stay tuned for potential upcoming changes, but until that time, please continue to practice as per the ALS PCS 4.5 seizure directive and the BLS PCS v3.01.