Comparison of prehospital glucose with or without IV thiamine

Mark A. Merlin, Alessia Carluccio, Neil Raswant, Frank DosSantos, Pamela Ohman-Strickland, David P. Lehrfeld

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)406-409
Number of pages4
JournalWestern Journal of Emergency Medicine
Volume13
Issue number5
DOIs
StatePublished - Nov 2012

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Thiamine
Glucose
Wernicke Encephalopathy
Hospital Emergency Service
Glasgow Coma Scale
Blood Pressure
Hypoglycemia
Emergency Medical Services
Respiratory Rate
Heart Rate
Research

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Merlin, M. A., Carluccio, A., Raswant, N., DosSantos, F., Ohman-Strickland, P., & Lehrfeld, D. P. (2012). Comparison of prehospital glucose with or without IV thiamine. Western Journal of Emergency Medicine, 13(5), 406-409. https://doi.org/10.5811/westjem.2012.1.6760

Comparison of prehospital glucose with or without IV thiamine. / Merlin, Mark A.; Carluccio, Alessia; Raswant, Neil; DosSantos, Frank; Ohman-Strickland, Pamela; Lehrfeld, David P.

In: Western Journal of Emergency Medicine, Vol. 13, No. 5, 11.2012, p. 406-409.

Research output: Contribution to journalArticle

Merlin, MA, Carluccio, A, Raswant, N, DosSantos, F, Ohman-Strickland, P & Lehrfeld, DP 2012, 'Comparison of prehospital glucose with or without IV thiamine', Western Journal of Emergency Medicine, vol. 13, no. 5, pp. 406-409. https://doi.org/10.5811/westjem.2012.1.6760
Merlin MA, Carluccio A, Raswant N, DosSantos F, Ohman-Strickland P, Lehrfeld DP. Comparison of prehospital glucose with or without IV thiamine. Western Journal of Emergency Medicine. 2012 Nov;13(5):406-409. https://doi.org/10.5811/westjem.2012.1.6760
Merlin, Mark A. ; Carluccio, Alessia ; Raswant, Neil ; DosSantos, Frank ; Ohman-Strickland, Pamela ; Lehrfeld, David P. / Comparison of prehospital glucose with or without IV thiamine. In: Western Journal of Emergency Medicine. 2012 ; Vol. 13, No. 5. pp. 406-409.
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