Blood glucose levels as an adjunct for prehospital field triage
| Autor: | Nachman Ash, Udi Katzenell, Avishai Elbaz, Gadi Lending, Alexander Morose, Ari M. Lipsky, Ilia Sergeev, Elon Glassberg |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Blood Glucose Male Emergency Medical Services Warfare medicine.medical_specialty Adolescent Likelihood ratios in diagnostic testing law.invention Physical trauma Young Adult Injury Severity Score Patient Admission law medicine Humans Registries Major injury Israel Intensive care medicine Retrospective Studies business.industry Field triage Retrospective cohort study General Medicine Intensive care unit Icu admission Intensive Care Units Emergency medicine Emergency Medicine Wounds and Injuries Female Triage business Biomarkers |
| Zdroj: | The American Journal of Emergency Medicine. 31:556-561 |
| ISSN: | 0735-6757 |
| Popis: | Elevated blood glucose levels (BGL) are known to be part of the physiologic response to stress following physical trauma. We aimed to study whether a measured BGL might help improve accuracy of field triage.We conducted a retrospective study using the Israel Defense Forces Trauma Registry. BGLs were determined upon hospital arrival and were not available to medical providers in the field.There were 706 casualties in the registry who had a recorded BGL upon hospital arrival. Sixty percent (18/30) of casualties who had a BGL ≥200 mg/dL had been triaged in the field as severely wounded, whereas 11% (71/651) of casualties who had a BGL200 mg/dL had been triaged as severely wounded. For predicting an Injury Severity Score15, the positive likelihood ratio using field triage of severe was 11, using BGL ≥200 mg/dL was 8, and using a combination of the two tests was 26. For predicting the need for intensive care unit (ICU) admission, the ratios were 8, 13, and 23, respectively.Elevated BGL improved prediction of high Injury Severity Score and ICU use among casualties triaged as severe. If future research using BGL measured in the field yields similar results, combining BGL with standard field triage may allow for more accurate identification of casualties who need acute field intervention, have major injury, or require ICU admission. |
| Databáze: | OpenAIRE |
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