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{
    "pk": 19203,
    "title": "Comparison of Prehospital Glucose with or without IV Thiamine",
    "subtitle": null,
    "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.\nMethods: 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.\nResults: 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.\nConclusion: 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. [West J Emerg Med. 2012;13(5):406-409.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "emergency medical services"
        },
        {
            "word": "Hypoglycemia"
        },
        {
            "word": "Thiamine"
        },
        {
            "word": "Wernicke’s Encephalopathy"
        },
        {
            "word": "Glucose."
        },
        {
            "word": "Emergency Medicine"
        },
        {
            "word": "Endocrinology, Diabetes, and Metabolism"
        },
        {
            "word": "Medical Nutrition"
        },
        {
            "word": "Medical Pharmacology"
        },
        {
            "word": "Medical Toxicology"
        },
        {
            "word": "Neurology"
        }
    ],
    "section": "Prehospital Care",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/0f92d5g4",
    "frozenauthors": [
        {
            "first_name": "Mark",
            "middle_name": "A.",
            "last_name": "Merlin",
            "name_suffix": "",
            "institution": "Newark Beth Israel Medical Center, Barnabas Health, Newark, New Jersey",
            "department": "None"
        },
        {
            "first_name": "Alessia",
            "middle_name": "",
            "last_name": "Carluccio",
            "name_suffix": "",
            "institution": "Mount Sinai Medical Center, New York City, New York",
            "department": "None"
        },
        {
            "first_name": "Neil",
            "middle_name": "",
            "last_name": "Raswant",
            "name_suffix": "",
            "institution": "University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine, Strafford, New Jersey",
            "department": "None"
        },
        {
            "first_name": "Frank",
            "middle_name": "",
            "last_name": "DosSantos",
            "name_suffix": "",
            "institution": "United States Navy",
            "department": "None"
        },
        {
            "first_name": "Pamela",
            "middle_name": "",
            "last_name": "Ohman-Strickland",
            "name_suffix": "",
            "institution": "University of Medicine and Dentistry of New Jersey, School of Public Health, Strafford, New Jersey",
            "department": "None"
        },
        {
            "first_name": "David",
            "middle_name": "P",
            "last_name": "Lehrfeld",
            "name_suffix": "",
            "institution": "University of Texas, Southwestern, Dallas Texas",
            "department": "None"
        }
    ],
    "date_submitted": "2011-04-04T21:50:26Z",
    "date_accepted": "2011-04-04T21:50:26Z",
    "date_published": "2012-09-18T22:26:04Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/19203/galley/9506/download/"
        }
    ]
}