In EMS, a glucometer should be used for which patients?

• A. Any patient with altered or decreased LOC
• B. Known diabetic history
• C. Neonates only
• D. None of the above

Answer: (A)

Testing blood glucose with a glucometer is essential when a patient has an altered or decreased level of consciousness because hypoglycemia is a common, reversible cause of AMS that requires prompt recognition and treatment. In the field, any patient who is not awake or not oriented should be checked for their glucose to avoid missing a life-threatening low (or high) level that could be rapidly corrected. If the reading is low, treat right away with simple carbohydrate if the patient can swallow and protect their airway, or with IV/IO dextose if they cannot. Relying on a known diabetic history isn’t enough, since AMS can occur in non-diabetics and a diabetic can be normoglycemic at times. Neonates also need glucose assessment when indicated, but testing all AMS patients is the most reliable approach.