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Case ref:201500671
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Date:December 2015
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Body:Scottish Ambulance Service
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Sector:Health
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Outcome:Some upheld, recommendations
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Subject:clinical treatment / diagnosis
Summary
Mr C, who is an advice worker, complained to us on behalf of Mr A. He said that Mr A has diabetes and had experienced a number of hypoglycaemic (low blood sugar) episodes. His colleagues had contacted the Scottish Ambulance Service (the service) to request an ambulance when he had another hypoglycaemic episode just before starting work. When the ambulance crew arrived, they carried out a blood glucose test, which showed that Mr A had hyperglycaemia (high blood sugar levels). Mr C complained that the ambulance crew had failed to take the blood glucose reading appropriately. He said that Mr A had spilled a sugary drink on his fingers. He stated that the ambulance crew had failed to clean Mr A's skin before carrying out the blood test and, because of this, the blood tests incorrectly showed that his blood sugar levels were very high.
We took independent advice on the complaint from an adviser in emergency medicine. We found that the ambulance crew should have cleaned Mr A's hands, using either soapy water or an alcohol wipe, before taking the blood glucose reading. This was to prevent getting a high reading in error, and also to reduce the chance of infection, which is a particularly high risk for diabetics. The evidence showed that the ambulance crew failed to clean Mr A's hands so we upheld this aspect of Mr C's complaint.
Mr C also complained that the ambulance crew then unreasonably took Mr A to the local hospital. However, ambulance crews are required to transport patients with hyperglycaemia to hospital. Although it was likely that the high blood sugar reading was due to the sugary drink on Mr A's skin, we found that the ambulance crew were required to take Mr A to hospital when the blood test showed that he had hyperglycaemia. We did not uphold this aspect of the complaint.
Recommendations
We recommended that the service:
- issue a written apology to Mr A for the failure to clean his skin appropriately before taking the blood glucose reading; and
- take steps to ensure that relevant staff are aware of the requirement to clean skin before taking a blood glucose reading.