Question: If we are presented with a hypoglycemic patient that demonstrates signs and symptoms of a TIA/CVA (slurred speech, inability to hold arms/legs up or due to confusion a grip test) and once the hypoglycemia is reversed with treatment and those signs and symptoms are gone, can we now deliver Ibuprofen/Acetaminophen or Ketorolac if the patient complains of CA related pain or muscle strain as per the Adult Analgesic Protocol?

 Given the difficulties in definitively ruling out a CVA /TIA based on response to correcting hypoglycemia SWORBHP Medical Council would consider ibuprofen and ketorolac to still be contraindicated / excluded in the scenario described.   However presence of CVA / TIA within the past 24 hours is not an exclusion criteria for Acetaminophen under the Adult Analgesic directive.

Analgesia,Hypoglycemia,Level of Consciousness,Pain/Sedation/Nausea

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