Determination of prehospital blood glucose: a prospective, controlled study.
OBJECTIVE
To determine if emergency medical personnel can effectively rule out hypoglycemia in the prehospital setting.


METHODS
During a 10-week period, emergency medical personnel determined the fingerstick glucose on all prehospital patients with altered mental status using the Chemstrip bG. Statistical comparisons were made to serum glucose levels performed by hospital laboratory personnel on blood samples obtained prior to glucose administration. A serum glucose level less than 60 mg/dL was considered a positive test for hypoglycemia.


METHODS
170 consecutive patients with altered mental status (AMS) ranging in age from 13 to 90 years were enrolled.


RESULTS
Of these patients, 158 were normal or hyperglycemic, 12 were hypoglycemic, and one patient was hypoglycemic but had only a borderline negative fingerstick test. Thus, a sensitivity of 91.7% and a negative predictive value of 99.3% were obtained. The specificity was 92.4%, and positive predictive value was 47.8%.


CONCLUSIONS
The Chemstrip bG may be used safely in the prehospital setting to rule out hypoglycemia.
Jones
J L
JL
Department of Emergency Medicine, East Carolina University School of Medicine/Pitt County Memorial Hospital, Greenville, North Carolina 27858-4354.
Ray
V G
VG
Gough
J E
JE
Garrison
H G
HG
Whitley
T W
TW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011934:Reagent Strips; D012680:Sensitivity and Specificity
D001786:Blood Glucose; D011934:Reagent Strips