TY - JOUR T1 - Evaluation of a diabetes referral pathway for the management of hypoglycaemia following emergency contact with the ambulance service to a diabetes specialist nurse team JF - Emergency Medicine Journal JO - Emerg Med J SP - 449 LP - 451 DO - 10.1136/emj.2005.028548 VL - 23 IS - 6 AU - A Walker AU - C James AU - M Bannister AU - E Jobes Y1 - 2006/06/01 UR - http://emj.bmj.com/content/23/6/449.abstract N2 - Objectives: To evaluate the effectiveness of ambulance crew referral of patients treated for acute hypoglycaemia, to a diabetes specialist nurse (DSN) team. Patients were assessed by the ambulance service and did not attend an emergency department. Methods: For a 3 month period patients were referred from two areas of West Yorkshire by the ambulance service to specialist diabetes teams. The DSNs contacted the patients within 7 days by telephone and arranged further review if necessary. Satisfaction questionnaires were sent to patients. Results: Thirty eight patients were referred and all were reviewed by telephone; 30 (79%) also required a clinic review appointment. Warning signs of hypoglycaemia were identified by 21 (55%) patients, but 14 (37%) had none (three had incomplete data). Twelve patients had had a self-treated episode in the previous 6 months; nine patients had had three or more. Fifteen (39%) patients had called an emergency ambulance for similar reasons in the previous 6 months (27 “999” calls). Twenty patients (53%) had their drug treatment altered at a clinic appointment and 14 (37%) required ongoing review. Twenty six patients returned the satisfaction questionnaire; of these 88% agreed or strongly agreed that they had improved their understanding of hypoglycaemia and 73% felt more able to treat a hypoglycaemic episode in the future. Patient satisfaction with this care pathway was high. Conclusions: The ambulance service can coordinate successful referral of patients with episodes of acute hypoglycaemia to a DSN-led service. Patients often required treatment review. They valued this service and felt more confident managing their diabetes. ER -