Posted 14 April 2012 - 02:03 AM
You see, when I first started out, there was this debate of whether to use the oral glucose in that fashion or not. One camp said yes, that the amount of glucose absorbed was enough to raise the BGL in a hypoglycemic patient. The other camp, of which I belonged to said no, that's not a good idea, introducing a foreign, sticky substance into the orophaynyx of an unconscious person was just asking for airway trouble. Debates were entertained. Arguments were had. Wars were waged.
Through the years I have come across services that recommend this procedure for administration of oral glucose, and others that specifically forbid it. So I decided one day to see if anyone had ever done a study about its effectiveness.
Lo and behold, the good people at the Journal of the American Medical Association did a study, and found that the amount of glucose absorption through the buccal membranes was less than 0.05 mg. In other words, it doesn't work. The title of the article, "Bioactivity of Instant Glucose, Failure of Absorption Through Oral Mucosa", was a big tip off. (Here's the link in case you don't believe me. http://www.ncbi.nlm....v/pubmed/691147 )
But here's the kicker: This study was done in 1978! Why in then name of all that is holy would anybody be arguing about this 30 some odd years later? How does that work? Really smart people did a lot of work and provided some conclusive evidence, some of the most conclusive evidence I've seen about a debated procedure. What hope is there for us to move into evidence based medicine when even when a conclusive study is done, the results are ignored? I don't get it.
Posted 14 April 2012 - 02:40 AM
If that doesn't work either 10% glucose IV for Paramedic and above or Technicians have glucagon
I'd rather give somebody some glucagon personally, less traumatic than shoving a drip in only to leave them at home
Edited by Kiwiology, 14 April 2012 - 02:40 AM.
Posted 14 April 2012 - 02:59 AM
Posted 14 April 2012 - 09:36 AM
Posted 14 April 2012 - 03:57 PM
Posted 14 April 2012 - 05:06 PM
Seriously though, it can be done. Just ask me about the PR Snickers Bar....
Edited by croaker260, 14 April 2012 - 05:08 PM.
Posted 14 April 2012 - 08:18 PM
Posted 14 April 2012 - 08:39 PM
Are there any studies to support the rectal route? Wasn't this one of crotchity's favorite things to talk about, rectal glucose?
From the late eighties up until about 2003 it was standard practice for the then-named Advanced Care Officer (Paramedic) to carry PR stesolid (diazepam) for seizures in addition to IV/IM midazolam
Apparently the diazepam suppository was "very easy" to slip in ... I'm just not going to think about it
Posted 14 April 2012 - 09:03 PM
Now I confuse ... you're giving them oral glucose to "absorb" through the oral mucosa? How interesting; seems like a bit of a waste of time; oral glucose paste is awfully sticky muck that does not lend itself to having a structure well suited for absorption; it's not you'd atomising a bit of midaz up their snoz or something.
Around here a patient is given 20ml of glucose if they can swallow it hmmm
Also tagged with one or more of these keywords: glucose, studies, mucous membranes
0 user(s) are reading this topic
0 members, 0 guests, 0 anonymous users