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Improving ambulance care during diabetic ketoacidosis

Project summary

Diabetic ketoacidosis (DKA) is a potentially life-threatening condition that occurs when someone with diabetes has a serious lack of insulin. It needs to be treated immediately and often leads to a hospital visit, but currently ambulances aren’t equipped with the equipment used to detect DKA. Dr Larissa Prothero wants to trial using this equipment in ambulances, to allow ambulance staff to treat DKA as quickly as possible. If successful, this could improve the quality of care people receive when experiencing DKA and reduce the risk of life-threatening DKA complications.

Background to research

DKA is a serious condition that happens when someone has a severe lack of insulin and very high blood sugar levels (hyperglycaemia). The body can’t use sugar for energy and starts to use fat instead. This causes ketones to be released, which can build up and make your blood become acidic. This can be potentially life-threatening and can often lead to hospitalisation.

The current clinical advice for ambulance workers is to not treat patients for DKA unless it can be confirmed. However, ambulances aren’t currently equipped with ketone meters which can be used to detect if someone with diabetes is in DKA. As a result, DKA may go undetected, and people are not likely to receive the appropriate care until they reach a hospital.

Research aims

Dr Prothero wants to find out if ambulance staff can reliably and safely identify cases of DKA using blood ketone meters, and then begin to treat the patient with IV fluids before reaching a hospital. Over eight months, 120 ambulance workers will use blood ketone meters to test for DKA in patients experiencing hyperglycaemia. If they test positive for DKA, the patients will be treated with IV fluids, and a message sent to the hospital, alerting them of the patient’s condition, so they can be properly treated on arrival.

The researchers will also carry out interviews and surveys with ambulance and hospital staff, to understand their experiences of current DKA care, and the benefits of using blood ketone monitors in an ambulance setting.

Potential benefit to people with diabetes

Early treatment of DKA is crucial in protecting the health of people living with diabetes. If this trial proves successful, Dr Prothero wants to expand the scale of the study, to see if adding blood ketone meters to ambulances improves the quality of care people with diabetes receive.

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