You respond to a call for a medical incident in the main base ski lodge. Near a fireplace just outside of the cafeteria you respond to an approximately 10-year-old child who is accompanied by a member of the cafeteria staff. The staff member says that they noticed that the child was alone and approached them to make sure they knew where their parents were. On speaking with the child, they found the child to be confused and disoriented.
You knee and speak with the child who identifies himself as Matthew, 9yo M. He knows nothing of his medical Hx. He is at the resort with his mother but doesn’t know her name or where she is. He is alert and verbally responsive but seems confused.
On examination Matthew has no external signs of trauma. He thinks he went skiing this morning, and he’s still wearing a helmet which shows no damage. His pupils are midrange and his eyes and face appear symmetrical. He has no weakness that you appreciate on his exam. His vital sigs are HR 95, RR 18, BP100/65, spO2 94%. He does seem confused, and he is slow to follow your commands, and frequently requires cues to follow through on your exam requests.
A second patroller arrives on scene with a gurney and med pack. While Matt is seated near the fireplace, you check his blood sugar using the glucometer and note that it is 47 mg/dl.
In response to Matt’s hypoglycemia, you have your partner obtain an apple juice and a cookie from the cafeteria. Matt is able to sit and drink the juice, and starts nibbling on the cookie. Thankfully, guest services is able to locate his mother, who comes to the scene. She had gone to the ski rental shop to swap boot sizes and left Matt waiting by the fire to rejoin him for lunch.
She tells you that Matt has had prior episodes of hypoglycemia, and is being evaluated by his doctor for this. He doesn’t have diabetes. He’s been with her all morning and hasn’t sustained any trauma or significant falls. Accordingly, you don’t place him in spinal precautions.