May 28, 2010

Use of glucometer testing to detect CSF leaks

Emerg Med J 2005;22:556-557 doi:10.1136/emj.2004.022111
  • Short report

New insights into the glucose oxidase stick test for cerebrospinal fluid rhinorrhoea


Rhinorrhoea is a clinical sign of cerebrospinal fluid (CSF) leakage in patients with skull fracture, but can also be attributable to respiratory secretions or tears. Laboratory tests confirming the presence of CSF are not sufficiently rapid to support clinical decision making in the emergency department and may not be universally available.
Detection of glucose in nasal discharge was traditionally used to diagnose CSF leak at the bedside, but has fallen into disuse as it has poor positive predictive value. We propose an algorithm to improve the diagnostic value of this test taking into consideration factors we have found to affect the glucose concentration of respiratory secretions. In patients at risk of CSF leak, nasal discharge is likely to contain CSF if glucose is present in the absence of visible blood, if blood glucose is <6 mmol.L−1, and if there are no symptoms of upper respiratory tract infection.

May 1, 2010

FREE CEU's - Emergency Preparedness Courses in SC


Preparedness Courses

For SC Pre-Hospital Personnel


(EMTs, paramedics, and other non-hospital emergency care personnel)
Brought to you by: SC DHEC and Emergency Services Special Operations Group

Mass Casualty Incidents/START Triage (Lecture with practical exercise/scenario) During a mass casualty incident (MCI), local resources will be overwhelmed. By utilizing the Simple Triage and Rapid Transport/Treatment method of sorting victims of an MCI responders will be able to “Do the best for the most.”
Meth Lab Awareness (Lecture)
Meth labs are more prevalent than ever and first responders need to know how to identify the properties and uses for methamphetamines, identify the hazards associated with and what actions to take when responding to a methamphetamine lab, and treat victims of a methamphetamine incident appropriately.
Pandemic Influenza (Lecture) Considerations for Emergency Medical Services participants will support the development of or review their organization’s pandemic influenza plan, know their role, and ensure they are ready to clinically respond in the event of pandemic influenza.
May 15th 
Greenville Tech, Pandemic Influenza for EMS and WMD Awareness
Berkeley County Emergency Services Training Center, START Triage and Meth Lab/IED
May 22nd  
Florence EMS Training Center, Pandemic Influenza for EMS and WMD Awareness
Lexington County EMS, START Triage and Meth Lab/IED
May 29th  
Berkeley County Emergency Services Training Center, Pandemic Influenza for EMS and WMD  
Greenville Tech., START Triage and Meth Lab/IED
June 5th  
Lexington County EMS, Pandemic Influenza for EMS and WMD Awareness
Florence EMS Training Center, START Triage and Meth Lab/IED

Session times: 10:00 a.m. – 3:00 p.m. Lunch is on your own from 12:00 to 1:00

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For additional information please contact:
C. J. Johnson, BHS, NREMT-P (Ret.), Owner/President, Emergency Services Special Operations Group, LLC, Medford, Oregon, 843-991-3928
Lorraine Dillon, MS, CHES, LPN, BT Training and Development Director, Division of EMS & Trauma, SC DHEC, (803) 545-4273,