Friday, September 27, 2013

Severe hypoglycaemia requiring emergency medical assistance by ambulance services in the East Midlands: A retrospective study

Publication date:

July 2013

SOURCE:Primary Care Diabetes, Volume 7, Issue 2

Author(s): Kamlesh Khunti , Harriet Fisher , Sanjoy Paul , Mohammad Iqbal , Melanie J. Davies , A. Niroshan Siriwardena

AimsTo report the characteristics and treatment of individuals requiring emergency ambulance services for severe hypoglycaemia and estimate associated provider costs.MethodsRetrospective analysis of routinely collected data collected by the East Midlands Ambulance Trust, UK, of episodes of severe hypoglycaemia attended by emergency ambulance services during a four-month period. Standard clinical measures, response time, on-site treatment and transportation were recorded and ambulance services costs calculated.Results90,435 emergency calls were recorded, 523 (0.6%) for severe hypoglycaemia, equating to an incidence of to 2.76 per 100 patient years; 74% of individuals were insulin-treated, 28% of events occurred nocturnally (00:00-07:59), and 32% were transported to hospital. Higher respiratory rate was a positive predictor (p=0.03), whereas higher post treatment blood glucose (p=0.05) and insulin treatment (p 0.01) were negative predictors of transport to hospital. Median treatment costs for individuals transported and not transported to hospital were EUR92 and EUR176 respectively.ConclusionsMost cases of severe hypoglycaemia requiring assistance from emergency ambulance services are successfully treated at the scene. Individuals not responding to treatment or were non insulin-treated were more likely to be transported to hospital. Further studies are needed to evaluate the effect of prehospital ambulance care by treatment and diabetes type on subsequent outcomes.
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