Question: Trauma and BGL. Is it imperative, at a traumatic event, when no signs of hypoglycemia where evident (e.g. guy on a bike hit by a car) to do a blood glucose reading even when a decreased LOA is present. Generally, does stressful events such as this not trigger a sympathetic response which would elevate the reading anyway? I understand if someone was acting different prior to such events. If BGL reading is to be done, when would the MAC feel it most appropriate to obtain, immediately or after package and in the truck? Thanks.

 Great question. Clearly many/most patients who have suffered major trauma and have an altered LOC most likely are suffering from a traumatic brain injury and not hypoglycemia as you correctly point out. That being said, the comprehensive assessment of any patient with an altered LOC would be to obtain a blood glucose determination as soon as feasible/practical given the circumstances. One never knows, the patient on the bike could have swerved into traffic related to their hypoglycemia/confusion and then sustained the traumatic injury.

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