Glucose, What's your highest?

[Arctickat]

Yeah, I think that's why my guy was so high, his potassium was 6.2 and white cells 32.5 x 10⁹/L. His remaining foot had a diabetic ulcer on it about the size of a toonie, a lovely shade of blue.

[chbare]

Just remember, the hyperkalaemia is relative. DKA patients are typically hypokalaemic and it is common to add KCl to IV fluids in spite of an elevated serum Potassium. These patients typically loose large amounts of K+ due to dieresis and the elevated serum K+ is due to extra cellular shifts becsuse of acidosis. It's not uncommon to see dramatic reductions in serum K+ following fluid resuscitation and insulin when the pH begins to increase and the anion gap begins to close.

[DwayneEMTP]

Responded to an altered patient, glucometer read "hi", it was reported by the ER that his labs showed 1,500 mg/dcl. He died the same night...unsure of comorbidities, but none physically apparent.

[Just Plain Ruff]

This was a friend of mine's glucose - 1540 along with a Potassium of 6.9 He's a pretty sick guy.

edited to fix my dyslexia on the potassium

Edited November 27, 2012 by Captain ToHellWithItAll

[BillKaneEMT]

Just over 1280 a month or so ago. He was a direct admit, bypassed the ER altogether. Didn't get any follow up info on him.

[1EMT-P]

The highest blood glucose I've ever had/seen was 1500 mg/dl. The patient was in his 30's and was in the hospital for 7 days. He had was sick with the flu and didn't take his medications for three days.

[krumel]

1852 mg/dl according to the hospital..The guy basically was a "medical multi-system-problem...Including MI, hyperglycaemia, etc. etc... He arrested when put on the stretcher, four more times in the ED and was declared 3h later...

[RuralKSEMS]

Transported one the other day that was 650 syrum levels, 7.1 pH, 6.5 potassium levels. Needless to say, he went from a rural hospital to a CCU in the larger city.

[Sequel]

The service I just completed my internship at had glucometers that tap out around 600 before reading only, "HI," however I treated a late 20s male pt with such a reading who was complaining of nausea/vomiting with pretty substantial abdominal pain, to the point we had to pick him up and move him and he fiercely guarded his abdomen after initial palpation. He had about 4-6 episodes of emesis just in the time I saw him and had been like that for a few days so I loaded him up with fluid. Good call, had never seen a really symptomatic DKAer before that.

[ChaseZ]

A little off topic but a really interesting case study about falsely high glucose readings in patients receiving Icodextrin for CAPD... http://www.anesthesia-analgesia.org/content/104/6/1473.full