Hypoglycaemia: fingerprick testing ruled out or in.

Clinical bottom line (level 1b)

  1. In patients with altered mental status who required ambulance assistance, hypoglycaemia was ruled out by fingerprick testing (sensitivity = 92%; LR- 0.1).
  2. In patients presenting with altered mental status and requiring ambulance assistance, fingerprick/reagent strips were reasonably predictive of hypoglycaemia (LR+12.1) .
Jones et al: J Emerg Med 1992; 10: 679-682
Expires January 2004

The study

Setting: ambulance service in urban US centre

170 patients (aged mean 48.6y, 61% male) altered mental status

Excluded if
  • received dextrose containing fluids or medications


    • visual reading of Chemstrip bG reagent strip
    Independent blinded reference standard, applied in all patients from a consecutive appropriate spectrum.

    The evidence

    pre-test probability of hypoglycaemia: 7%, (95% CI: 3.2% to 10.9%)

    diagnostic test number of patients sensitivity for
    hypoglycaemia (lab blood glucose <60mg/dL)
    (95% CI)    		 specificity for
    hypoglycaemia (lab blood glucose <60mg/dL)
    (95% CI)    		 LR+ LR-
    hypoglycaemia by reagent strip 11 92%
    (88% to 96%)     		92%
    (82% to 96%)     		12.1 0.1
    normal or raised blood glucose by reagent strip 1 %
    (% to %)
    total

    Comments

    1. Good study testing a diagnostic tool in the place it will be used.

    Citation

    1. Jones JL, Ray VG, Gough JE, et al: Determination of prehospital blood glucose: a prospective, controlled study.. J Emerg Med 1992; 10: 679-682
    Contributor: Matt Taylor and Bob Phillips, September 1999
    Reviewer:

    Clinical Question.
    Patient In patients with altered mental status who received ambulance care
    Intervention or Exposure does fingerprick glucose on a reagent strip
    Outcome reflect laboratory values