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What is A middle-aged man comes after a road traffic accident with bleeding from the scalp. He is unconscious. A card in his pocket reveals that he is a known diabetic on Tab Glimepiride + Metformin 2 tablets twice daily. What should the next step in management? and explain in detail?
Ans: D.Airway, CT scan. Blood sugar if <70 sta dextrose (Ref Harrison 19/e p2435, 18/e p3008; ATLS 9/e 2013; 72(5): p1363-1366)First testing of blood sugar necessary before glucose administration for dehydration.To rule out diabetic ketoacidotic coma rather than hypoglycemia.Non-contrast head CT (NCCT):Advisable in emergency situations.To avoid cerebral edema due to glucose administration.