Ambulance clinician use of capillary blood ketone meters to improve emergency hyperglycaemia care: A stepped‐wedged controlled, mixed‐methods feasibility study
Authors' conclusion
Ambulance capillary blood ketone meter use was deemed feasible, safe and acceptable. Opportunities for improved clinical decision making, support and safety-netting, as well as in-hospital DKA care, were recognised. As participant recruitment was below progression threshold, it is recommended that future-related research considers alternative trial designs.
Study context
- Population
- Ambulance patients with hyperglycaemia (capillary blood glucose >11.0 mmol/L) or diabetes and unwell; plus 20 ambulance and ED clinicians interviewed20 clinicians interviewed
- Participants
- 388 patients
- Comparison
- Ambulance capillary blood ketone meter use with paramedic-led fluid therapy for 'high-risk' diabetic ketoacidosis (DKA) vs control
- Interventionn = 185
- Controln = 203reference
- Outcome
- Feasibility, safety and acceptability of ambulance clinician use of capillary blood ketone meters for 'high-risk' DKA recognition and fluid initiation
Methodological detailsstepped-wedge controlled
- Stepped-wedge controlled
Main finding
As reported in the abstract
'High-risk' DKA identification
Further findings
Pre-hospital fluid therapy in hospital-diagnosed DKA participants
Diabetes type among participants
- T1D
- 18.5%
- T2D
- 74.3%
Clinician interviews
- Key themes: clinical assessment, ambulance DKA fluid therapy, clinical handovers; decision support tool; hospital DKA management; barriers to hospital DKA care
Original publication
Ambulance clinician use of capillary blood ketone meters to improve emergency hyperglycaemia care: A stepped‐wedged controlled, mixed‐methods feasibility study. Diabet Med. Published 9 June 2024. doi:10.
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