title: Evaluation of pediatric glucose monitoring and hypoglycemic therapy in the field.
abstract: As specific indications for glucose monitoring in pediatric patients are not standardized, we sought to evaluate our EMS system regarding the use of this test, so that objective data can be used for prehospital provider education. We performed a 5-year electronic search of prehospital records to assess pediatric patients who had glucose monitoring performed, with subgroup analysis on those requiring therapy. We found that 6018 pediatric patients received glucose monitoring with the most common chief complaints for testing including: seizure, "other medical," trauma head/neck, and OD/poisoning. Of these, 270 (4.5%) required therapy for hypoglycemia with an additional 100 (1.7%) patients receiving treatment without use of the paramedic's monitor. Age breakdowns for therapy were as follows: 0-4 years, 44 (11.9%); 5-9, 36 (9.7%); 10-14, 58 (15.7%); 15-19, 232 (62.7%). In the prehospital setting, the need to treat hypoglycemia in pediatric patients is infrequent. The chief complaints associated with the highest frequencies of hypoglycemia are seizures and altered neurologic status.
authors.affiliation: Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, CA, USA. gmvilke@ucsd.edu
authors.forename: Gary M
authors.initials: GM
authors.lastname: Vilke
authors.forename: Edward M
authors.initials: EM
authors.lastname: Castillo
authors.forename: Leslie Upledger
authors.initials: LU
authors.lastname: Ray
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Murrin
authors.forename: Theodore C
authors.initials: TC
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians; D005260:Female; D005934:Glucagon / Q000627:therapeutic use; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000188:drug therapy*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D005934:Glucagon; D005947:Glucose