Immediate management

• Measure glucose rapidly using reagent strips ^{a b} or a capillary blood glucose in triage ^a

Why?

Normoglycaemia on a reagent strip makes hypoglycaemia unlikely

Patient	Target Disorder and Reference Standard	Diagnostic Test	LR+ (95% CI)	Post-test Probability	LR- (95% CI)	Post-test Probability
altered mental status a (pre-test probability: 7%)	hypoglycaemia (blood glucose)	reagent strip	12.1 (6.8 to 21)	48%	0.090 (0.014 to 0.60)	0.68%

• Immediate blood glucose measurement reduces time to definitive care (mean 2 hours to nursing care, 1 hour to medical care) ^a