Category: Stroke Bypass

Rationale for hypoglycemia 3mmol/L contraindication

Question #: 478


Why is an untreated BGL of 3.0 mmol/L a contraindication for the acute stroke bypass protocol when the ALS PCS definition of hypoglycemia for patients 2 years and older is BGL 4.0mmol/L?


When the patient presents with hypoglycemia 3mmol/L and acute signs of stroke, it is recommended to first manage hypoglycemia, prior to making transport destination decision. A glucometry 3mmol/L usually mimics acute stroke-like symptoms. You are faced with two probable working diagnoses. Treating hypoglycemia first allows you to tailor the transport/destination decision to the patient's needs. If the patient presents with hypoglycemia 3-4mmol/L and acute signs of stroke, it is most likely a stroke and a bypass decision can be made right away. Note that glucometry findings between 3-4mmol/L normally presents with milder signs and symptoms and is well tolerated by most patients.

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