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Comparison of Prehospital Glucose with or without IV Thiamine.
MedLine Citation:
PMID:  23359624     Owner:  NLM     Status:  PubMed-not-MEDLINE    
INTRODUCTION: Loading of thiamine prior to glucose administration during hypoglycemia to prevent Wernicke's encephalopathy is routine in the prehospital setting. To date no study has looked at the validity of this therapy.
METHODS: We evaluated a retrospective cohort of 242 patients who received intravenous glucose for hypoglycemia comparing those who received thiamine supplementation versus those who did not. Study endpoints were heart rate, blood pressure, Glasgow Coma Scale (GCS), reentry into the 911 system, and emergency department (ED) discharge rates.
RESULTS: There were no significant differences between the thiamine, and without-thiamine groups. All patients were discharged neurologically intact or were alert and oriented when refusing transport to the hospital. None of the 242 patients re-called 911 within the immediate 24-hour period or returned to the ED.
CONCLUSION: To our knowledge this is the first study in the literature which evaluated the use of thiamine with glucose to prevent Wernicke's encephalopathy in the prehospital setting. We found that routine administration of thiamine with glucose did not result in differences in respiratory rate, systolic blood pressure, GCS or ED hospital discharge rates. Until further research is done to validate our results emergency medical services leadership should consider whether the routine use of thiamine in the prehospital setting is appropriate for their system.
Mark A Merlin; Alessia Carluccio; Neil Raswant; Frank Dossantos; Pamela Ohman-Strickland; David P Lehrfeld
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The western journal of emergency medicine     Volume:  13     ISSN:  1936-900X     ISO Abbreviation:  West J Emerg Med     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2013-01-29     Completed Date:  2013-01-30     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  101476450     Medline TA:  West J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  406-9     Citation Subset:  -    
Newark Beth Israel Medical Center, Barnabas Health, Newark, New Jersey.
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