EMS Protocol of the Week - Hyperglycemia (Adult and Pediatric)

We're not quite at the point yet where EMS will initiate insulin therapy in the field, so for the time being, the prehospital approach to hyperglycemia mainly involves the recognition oh hyperglycemic emergencies. This means that, in addition to checking for an elevated glucometer reading, EMTs and paramedics will assess for altered mental status, dehydration, or tachypnea (ie, Kussmaul breathing compensating for DKA). ALS units will likely obtain vascular access and start fluid resuscitation on these patients, so be sure to confirm how much crystalloid was given during transport (if any) when calculating your own fluid repletion strategies. From there, the rest is up to you!

Have fun closing the gap! www.nycremsco.org and the protocol binder for more.

Dave