Incidence and Disposition of Diabetic Emergencies by Paramedic Services in Halton, Ontario

OBJECTIVETo review the incidence and type of disposition of diabetic emergencies treated in the community by paramedic services.METHODAll paramedic records over a 1 year period for a regionally operated emergency medical service (EMS) in Halton, Ontario, were reviewed for ambulance calls involving diabetic emergencies or capillary blood glucose (CBG) level <4.0mmol/L.RESULTSThere were 31 171 ambulance calls during the 1 year review period. 3.8% of ambulance calls (1169/31 171) met the inclusion criteria of being coded as a diabetic emergency or involving a CBG <4.0mmol/L. Only 34.8% (407/1169) of ambulance calls coded as diabetic emergencies had a CBG recorded in the charts. Of those ambulance calls involving a patient with a CBG <4.0mmol/L, 44.6% (165/370) were treated in the community and not transported to a hospital emergency department.CONCLUS IONParamedics treat a significant number of people with diabetic emergencies in the community and do not transport them to emergency departments. Analysis using only emergency department data may significantly underestimate the incidence of hypoglycemia in the community.We raise the point that there may be more hypoglycemic events in the community that require the assistance of a second party than is demonstrated by emergency room data alone. Further study of the incidence of hypoglycemia in the community is required.