GRBS Assessment for Seizures

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Stanoson

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I need a clarification for a case I have come across. An 18 yr old Female patient with Seizures, Her LOC is alert an GCS sclae is 15/15. Is there a requirement to check GRBS? if so why?
 
Stanoson said:
I need a clarification for a case I have come across. An 18 yr old Female patient with Seizures, Her LOC is alert an GCS sclae is 15/15. Is there a requirement to check GRBS? if so why?
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What is GRBS?
A blood sugar?
 
Grand Rapids Building Service?
 
I personally do not consider it an absolute requirement, but because blood sugar problems can provoke seizures in anyone, it's a good idea to check it. If she is alert, oriented, without acute neurological deficits, has a history of epilepsy, and you didn't have to correct her sugar for her to return to baseline, I would think a blood sugar problem would be unlikely.
 
GRBS?? LOL, do we need any more pointless acronyms?

Sure, prick the finger, check the sugar. IF she had a seizure prior to your arrival and is now A/O x 4, checking the BGL is absolutely an appropriate objective assessment to perform.

Let me turn the question around on you....Why would you NOT want to do this test? What about the patient, her history or assessment would make you decide to NOT go this one extra step?
 
The chance that a patient would have a seizure or other brief alteration in consciousness and then resolves to baseline without any intervention as the result of a blood sugar drop is essentially zero. A patient that seizes from hypoglycemia is not miraculously going to be asymptomatic after the seizure, the same goes for every DFO you get at a birth when the husband sees the miracle of life.

That being said I think almost every EMS protocol is going to require or recommend a blood sugar check with an alteration in consciousness, seizures included. I also don't see any real risk to checking a BGL so in a non-resource limited environment I don't really think there is a good reason not to do it. I would also consider that often we check them (as well as many other labs) in order to prepare the chart for review; whether it be legal, peer review, or whatever else.
 

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Even though I feel her BGL wouldn’t be the issue if she came back to baseline on her own, it doesn’t hurt to just check it 🤷🏼‍♂️ The ER will ask anyways. Last PT I had during internship that seized and we got there and was 15/15 GCS I did a sugar, 4 lead, 12 lead and thorough assessment just to check off every possible differential. She ended up signing AMA anyways
 
Stanoson said:
I need a clarification for a case I have come across. An 18 yr old Female patient with Seizures, Her LOC is alert an GCS sclae is 15/15. Is there a requirement to check GRBS? if so why?
Click to expand...
My dear friend,
As the comments here have shown,
Your question was confusing,
As you used an acronym,
"GRBS".
In 20 years of EMS,
perhaps more,
I've not ever read these four letters together,
without some type of punctuation.
Please take this to heart.
 
Why would anyone or any place put Random in a Blood Glucose check acronym? What is random about it? Only way it would be random is if you checked everyone on scene and picked 1 of them randomly to put in the report

Some Medical Director somewhere is writing protocols while he is drunk lol
 
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