r/medizzy • u/GiorgioMD • 41m ago
Found down behind a bar. Known heavy drinker, confused, sweaty, glucometer says 48. Your partner is already drawing up the D50 when the medic who trained him says "thiamine first." Who's right?
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45M, long history with the bottle, found confused and combative-ish behind a bar. Tachycardic, pressure soft, looks dry, a little yellow. BGL: 48.
Your partner reaches for the dextrose. The senior medic on scene stops him: "Alcoholic. Thiamine before glucose, always. You'll give him Wernicke's."
So, the thread's homework: who wins this argument and why? Is "thiamine before glucose" a real rule, a half-rule, or a medical ghost story we keep passing down? And while they argue about vitamins, what are YOU doing about the pressure?
I know some of your protocols still have this carved in stone. Let's hear them.
Case adapted from the EMS Mastery (NREMT prep) question bank.
