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Prehosp Emerg Care. 2017 Nov-Dec;21(6):767-772. doi: 10.1080/10903127.2017.1321707. Epub 2017 Jun 22.

Hypoglycemia Patients and Transport by EMS in Alameda County, 2013-15.

Abstract

OBJECTIVE:

To estimate the rate, characteristics, and dispositions of hypoglycemia events among persons who received care from Alameda County, California, Emergency Medical Services (EMS).

METHODS:

This study was based on data for 601,077 Alameda County EMS encounters during 2013-15. Subjects were defined as having hypoglycemia if EMS personnel recorded a primary impression of hypoglycemia or low blood glucose (<60 mg/dl or "unspecified low"). The outcome of interest was patient transport or non-transport to an emergency department or other care setting; we excluded 33,177 (6%) encounters which lacked clear disposition outcomes.

RESULTS:

Among 567,900 eligible encounters, 8,332 (1.47%) were attributed to hypoglycemia, of which 1,125 (13.5%) were not transported. Non-transport was more likely among males, adult patients age <60, initial blood glucose >60 mg/dl or EMS arrival time 18:00-6:00.

CONCLUSIONS:

Without an understanding of EMS encounters and non-transport rates, surveillance based solely on emergency department and hospital data will significantly underestimate rates of severe hypoglycemia. Additionally, given that hypoglycemia is often safely and effectively treated by non-physicians, EMS protocols should provide guidance for non-transport of hypoglycemic patients whose blood glucose levels have normalized.

KEYWORDS:

blood glucose; diabetes mellitus; emergency medical services; hypoglycemia; public health surveillance; transportation of patients

PMID:
28641035
PMCID:
PMC5668170
DOI:
10.1080/10903127.2017.1321707
[Indexed for MEDLINE]
Free PMC Article

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