Question: How fast can a pediatric Pt. burn through glucose stores? Scenario: Called for a 13y/o unconscious. Consumption of unknown amount of alcohol & unknown drugs or amount. AOx0, GCS 4=E2V1M1. Eyes open to pain as only response. Pt stable vital signs on Primary & throughout transport & BGL 5.8mmol/L on scene. Transport to appropriate children's hospital code 4 CTAS 2with a 25 min transport time. On ED assessment Pt. was given an amp of dextrose as ED found BGL to be "low".... or not able to read on meter, so possibly less than 1.6mmol/L. Crew's service meter DID pass daily test procedure as per manufacturer's guidelines. Thank you
Given the polysubstance overdose (alcohol and unknown drugs), and other innate factors related to glucose production and metabolism it would be impossible to give a time frame when and if to expect hypoglycemia after an initial normal reading. It should be noted that alcohol is more likely to cause hypoglycemia in pediatric patients due to its effect on the ability for glucose to be generated by the liver and the potential overproduction of insulin.
Should the patients status deteriorate, then repeating the blood glucose in any unwell patient would be prudent.
In the case of this longer transport time and with the knowledge that pediatric patients are more likely to experience hypoglycemia from the effects of alcohol or other toxicological ingestions, paramedics can use their clinical judgement as to whether or not to ascertain another glucose reading during these prolonged transport times when there is no improvement or deterioration of a patients level of consciousness.