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Hypoglycemia in multiple trauma victims

W J Brady1, K Butler, R Fines

  • 1Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville 22906-0014, USA.

The American Journal of Emergency Medicine
|February 3, 1999
PubMed
Summary
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Hypoglycemia in trauma patients with altered mental status is rare but can mimic serious injury. Early bedside glucose testing is crucial for rapid diagnosis and treatment, especially in patients with diabetes.

Area of Science:

  • Emergency Medicine
  • Clinical Diagnostics
  • Trauma Care

Background:

  • Altered mental status in trauma patients often suggests severe injury.
  • Hypoglycemia can present with symptoms mimicking traumatic brain injury.
  • The incidence of hypoglycemia in trauma is not well-established.

Purpose of the Study:

  • To determine the incidence of hypoglycemia in trauma patients with altered mental status.
  • To evaluate the effectiveness of bedside glucose testing in this population.
  • To highlight the importance of considering hypoglycemia in trauma evaluations.

Main Methods:

  • Retrospective review of adult trauma patients with Glasgow Coma Scale (GCS) <15.
  • Inclusion criteria: presentation to a university hospital emergency department (ED) from July 1995 to August 1996.

Related Experiment Videos

  • Hypoglycemia defined as serum glucose <60 mg/dL; bedside and laboratory glucose testing analyzed.

    • Main Results:

    • Four cases (0.4%) of hypoglycemia identified in 926 eligible trauma patients.
    • Two cases diagnosed rapidly via bedside screening (mean 7 minutes).
    • Dextrose therapy improved mental status in affected patients.

    Conclusions:

    • Hypoglycemia is rare in trauma patients with abnormal GCS scores but can mimic significant injury.
    • Bedside glucose screening is a rapid diagnostic tool in the ED.
    • Physicians should consider hypoglycemia in trauma patients with risk factors like diabetes or alcohol use.