Evidence-based On-call

Coma

Immediate management

If you believe hypoglycaemia is present, try a test dose of 50% glucose intravenously ^c

Why?

A full recovery following 50% glucose diagnosing hypoglycaemia

Patient	Target Disorder and Reference Standard	Diagnostic Test	LR+ (95% CI)	Post-test Probability
altered mental consciousness ^c (pre-test probability: 9%)	hypoglycaemia (blood glucose or clinical diagnosis)	complete response to 50% glucose	43 (18 to 110)	80%
		partial response to 50% glucose	1.2 (0.47 to 3.2)	10%
		no response to 50% glucose	0.20 (0.089 to 0.44)	1.8%