Читать книгу Emergency Medical Services - Группа авторов - Страница 367

The measurement of serum glucose should be a universal step in the evaluation of an AMS patient. Hypoglycemia may be the sole and reversible cause of AMS in some EMS encounters. Although the defined level for hypoglycemia varies from system to system, many use a level of less than or equal to 70 mg/dL when accompanied by appropriate signs and symptoms of hypoglycemia. A method of testing then treating is generally preferable to the empiric administration of exogenous glucose to all patients with AMS. Only 25% of patients with AMS are hypoglycemic. The common assumption that an ampule of dextrose 50% in water “won’t hurt anyone” has been refuted [11], and it is well established that the blind administration of exogenous glucose may be harmful [12, 13]. After administration of dextrose to the known hypoglycemic patient, an improvement in mental status is usually seen within 5 minutes (see Chapter 20).