ExacTech blood glucose meter clinical trial.

E. A. Bartkus, Mohamud Ramzan Daya, J. R. Hedges, Jonathan Jui

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

INTRODUCTION: Current prehospital protocols for the management of patients with altered mental status include the empiric administration of hypertonic glucose, naloxone, and thiamine. The injudicious use of 50% dextrose (D50W) may result in hyperosmolarity, a worsening of hypokalemia, and unwarranted additional health-care costs for the patient. The administration of D50W also may worsen the neurological outcome of patients with local or generalized ischemia. OBJECTIVE: To evaluate the ExacTech blood glucose meter's ability to estimate blood glucose levels accurately and rapidly. METHODS: Emergency medical technicians (EMTs) from selected advanced life support (ALS) units in the Portland, Ore., metropolitan area participated in a prospective clinical trial of the ExacTech blood glucose meter. A convenience sample was drawn from emergency medical services (EMS) patients with suspected diabetic emergencies, altered mental status, and other neurological deficits. Venous blood samples were drawn from these populations at the same time as the ExacTech readings were obtained. The venous blood was submitted to the receiving hospitals for laboratory analysis of blood glucose levels, and a comparison was made between the results of the two methods. RESULTS: A total of 80 matched sets of data were obtained from 1 April 1990 through 6 May 1991. The hospital blood glucose values ranged from 8 to 1233 mg/dl. Sixteen (20%) of the patients were hypoglycemic (&.lt.60 mg/dl) and 23 (28.8%) were hyperglycemic ( greater than 180 mg/dl). The ExacTech device sensitivity and specificity for hypoglycemia using venous samples were 94.6% and 89.2%, respectively. For hyperglycemia, these same parameters were 87.5% and 97.1%. Pearson's r over the range of the instrument (40-450 mg/dl) was 0.8656 (p less than .001). If the prehospital "definition" of hypoglycemia (for threshold-to-treat) is raised to 65 mg/dl, the device has 100% sensitivity in the sample population. CONCLUSION: The device functioned accurately and consistently in the prehospital environment over a wide range of temperatures, and in the hands of many different individuals.

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Blood Glucose
Clinical Trials
Hypoglycemia
Equipment and Supplies
Emergency Medical Technicians
Glucose
Hospital Laboratories
Hypokalemia
Thiamine
Emergency Medical Services
Naloxone
Hypoglycemic Agents
Hyperglycemia
Health Care Costs
Population
Reading
Emergencies
Ischemia
Sensitivity and Specificity
Temperature

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{59cf21c5c2534657bb6c8d2c7b22d8f0,
title = "ExacTech blood glucose meter clinical trial.",
abstract = "INTRODUCTION: Current prehospital protocols for the management of patients with altered mental status include the empiric administration of hypertonic glucose, naloxone, and thiamine. The injudicious use of 50{\%} dextrose (D50W) may result in hyperosmolarity, a worsening of hypokalemia, and unwarranted additional health-care costs for the patient. The administration of D50W also may worsen the neurological outcome of patients with local or generalized ischemia. OBJECTIVE: To evaluate the ExacTech blood glucose meter's ability to estimate blood glucose levels accurately and rapidly. METHODS: Emergency medical technicians (EMTs) from selected advanced life support (ALS) units in the Portland, Ore., metropolitan area participated in a prospective clinical trial of the ExacTech blood glucose meter. A convenience sample was drawn from emergency medical services (EMS) patients with suspected diabetic emergencies, altered mental status, and other neurological deficits. Venous blood samples were drawn from these populations at the same time as the ExacTech readings were obtained. The venous blood was submitted to the receiving hospitals for laboratory analysis of blood glucose levels, and a comparison was made between the results of the two methods. RESULTS: A total of 80 matched sets of data were obtained from 1 April 1990 through 6 May 1991. The hospital blood glucose values ranged from 8 to 1233 mg/dl. Sixteen (20{\%}) of the patients were hypoglycemic (&.lt.60 mg/dl) and 23 (28.8{\%}) were hyperglycemic ( greater than 180 mg/dl). The ExacTech device sensitivity and specificity for hypoglycemia using venous samples were 94.6{\%} and 89.2{\%}, respectively. For hyperglycemia, these same parameters were 87.5{\%} and 97.1{\%}. Pearson's r over the range of the instrument (40-450 mg/dl) was 0.8656 (p less than .001). If the prehospital {"}definition{"} of hypoglycemia (for threshold-to-treat) is raised to 65 mg/dl, the device has 100{\%} sensitivity in the sample population. CONCLUSION: The device functioned accurately and consistently in the prehospital environment over a wide range of temperatures, and in the hands of many different individuals.",
author = "Bartkus, {E. A.} and Daya, {Mohamud Ramzan} and Hedges, {J. R.} and Jonathan Jui",
year = "1993",
month = "7",
language = "English (US)",
volume = "8",
pages = "217--227",
journal = "Prehospital and Disaster Medicine",
issn = "1049-023X",
publisher = "World Association for Disaster and Emergency Medicine",
number = "3",

}

TY - JOUR

T1 - ExacTech blood glucose meter clinical trial.

AU - Bartkus, E. A.

AU - Daya, Mohamud Ramzan

AU - Hedges, J. R.

AU - Jui, Jonathan

PY - 1993/7

Y1 - 1993/7

N2 - INTRODUCTION: Current prehospital protocols for the management of patients with altered mental status include the empiric administration of hypertonic glucose, naloxone, and thiamine. The injudicious use of 50% dextrose (D50W) may result in hyperosmolarity, a worsening of hypokalemia, and unwarranted additional health-care costs for the patient. The administration of D50W also may worsen the neurological outcome of patients with local or generalized ischemia. OBJECTIVE: To evaluate the ExacTech blood glucose meter's ability to estimate blood glucose levels accurately and rapidly. METHODS: Emergency medical technicians (EMTs) from selected advanced life support (ALS) units in the Portland, Ore., metropolitan area participated in a prospective clinical trial of the ExacTech blood glucose meter. A convenience sample was drawn from emergency medical services (EMS) patients with suspected diabetic emergencies, altered mental status, and other neurological deficits. Venous blood samples were drawn from these populations at the same time as the ExacTech readings were obtained. The venous blood was submitted to the receiving hospitals for laboratory analysis of blood glucose levels, and a comparison was made between the results of the two methods. RESULTS: A total of 80 matched sets of data were obtained from 1 April 1990 through 6 May 1991. The hospital blood glucose values ranged from 8 to 1233 mg/dl. Sixteen (20%) of the patients were hypoglycemic (&.lt.60 mg/dl) and 23 (28.8%) were hyperglycemic ( greater than 180 mg/dl). The ExacTech device sensitivity and specificity for hypoglycemia using venous samples were 94.6% and 89.2%, respectively. For hyperglycemia, these same parameters were 87.5% and 97.1%. Pearson's r over the range of the instrument (40-450 mg/dl) was 0.8656 (p less than .001). If the prehospital "definition" of hypoglycemia (for threshold-to-treat) is raised to 65 mg/dl, the device has 100% sensitivity in the sample population. CONCLUSION: The device functioned accurately and consistently in the prehospital environment over a wide range of temperatures, and in the hands of many different individuals.

AB - INTRODUCTION: Current prehospital protocols for the management of patients with altered mental status include the empiric administration of hypertonic glucose, naloxone, and thiamine. The injudicious use of 50% dextrose (D50W) may result in hyperosmolarity, a worsening of hypokalemia, and unwarranted additional health-care costs for the patient. The administration of D50W also may worsen the neurological outcome of patients with local or generalized ischemia. OBJECTIVE: To evaluate the ExacTech blood glucose meter's ability to estimate blood glucose levels accurately and rapidly. METHODS: Emergency medical technicians (EMTs) from selected advanced life support (ALS) units in the Portland, Ore., metropolitan area participated in a prospective clinical trial of the ExacTech blood glucose meter. A convenience sample was drawn from emergency medical services (EMS) patients with suspected diabetic emergencies, altered mental status, and other neurological deficits. Venous blood samples were drawn from these populations at the same time as the ExacTech readings were obtained. The venous blood was submitted to the receiving hospitals for laboratory analysis of blood glucose levels, and a comparison was made between the results of the two methods. RESULTS: A total of 80 matched sets of data were obtained from 1 April 1990 through 6 May 1991. The hospital blood glucose values ranged from 8 to 1233 mg/dl. Sixteen (20%) of the patients were hypoglycemic (&.lt.60 mg/dl) and 23 (28.8%) were hyperglycemic ( greater than 180 mg/dl). The ExacTech device sensitivity and specificity for hypoglycemia using venous samples were 94.6% and 89.2%, respectively. For hyperglycemia, these same parameters were 87.5% and 97.1%. Pearson's r over the range of the instrument (40-450 mg/dl) was 0.8656 (p less than .001). If the prehospital "definition" of hypoglycemia (for threshold-to-treat) is raised to 65 mg/dl, the device has 100% sensitivity in the sample population. CONCLUSION: The device functioned accurately and consistently in the prehospital environment over a wide range of temperatures, and in the hands of many different individuals.

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