Monday, April 25, 2016

Unresponsive? Check sugar ..Check sugar..

This has not happened to me. But to one of my senior doctor. 
It was a rural hospital with minimum facilities. The doctor was called to attend an unresponsive patient. He has checked airway, breathing , circulation. Yes. fine. He immediately filled the transfer form & arranged the ambulance to transfer the patient after discussing with seniors & destination hospital.

For some reason, without any cross questioning his transfer also approved by a senior doctor. Now the destination hospital is waiting to intubate the patient & busy with arranging ICU. Once after they started the journey, that junior has suddenly remembered something & checked the sugar. It was 25mg/dl !!! Patient who was about be intubated in few minutes woke up with few milliliters of dextrose & went SEATED to the destination!! 
Same happened to me sometime back. I was almost about to jump on one unresponsive patient's chest to give CPR & to break all his ribs.. He was lucky. I was figured to check RBS.. Oh.. 35 mg/dl..
He could save his rib cage with life after few milliliters of dextrose.

Lesson- Stick to the basics. A-B-C-D (Dextrose).
Unresponsive patient -always check the sugar level.

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