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Appropriateness of leaving emergency medical service treated hypoglycemic patients at home: a retrospective study

S Anderson1, P D Høgskilde, J Wetterslev

  • 1H:S Laegeambulancen, HovedOrtoCentret, Department of Anesthesia, Copenhagen University Hospital, Denmark.

Acta Anaesthesiologica Scandinavica
|April 16, 2002
PubMed

Insights

Most patients with prehospital hypoglycemia can be safely treated and released at home by emergency medical services (EMS). This retrospective study validated criteria for home release, finding low rates of secondary complications.

Area of Science:

  • Emergency Medicine
  • Diabetology
  • Public Health

Background:

  • Prehospital hypoglycemia management by emergency medical services (EMS) often involves leaving patients at home.
  • The criteria and appropriateness of releasing hypoglycemic patients at home require validation.

Purpose of the Study:

  • To validate criteria for home release of hypoglycemic patients treated by an EMS.
  • To assess the safety and appropriateness of the home release procedure for prehospital hypoglycemia.

Main Methods:

  • Retrospective analysis of prehospital data from a physician-based mobile intensive care unit (MICU) from 1995-1998.
  • Cross-referencing with national registries for patient identification and 72-hour follow-up.
  • Identifying predictors for hospital transportation and evaluating outcomes for patients released at home.

Main Results:

  • 84% of 1148 treated hypoglycemic patients were released at home.
  • Level of consciousness and pre-MICU treatment were key predictors for hospital transportation.
  • Less than 8% of home-released patients required secondary treatment; recurrent hypoglycemia was rare (<5%).

Conclusions:

  • The majority of prehospital hypoglycemia cases can be safely managed and released at home within a physician-based EMS system.
  • Established criteria support the safe release of hypoglycemic patients, minimizing the need for hospital admission.
  • Poor diabetic treatment compliance was a factor in recurrent hypoglycemia cases.
Abstract

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