Question

Following a motor vehicle accident, your patient has a suspected head injury. The patient is placed in the semi-Fowler's position. You notice a clear fluid running out of the patient's nose. You should test the fluid for a presence of what?

a) glucose
b) potassium
c) sodium
d) blood
e) bacteria

Answer 1

Clear fluid running from a patient's nose following a head injury should be tested for glucose (option a) as a proxy for cerebrospinal fluid. CSF contains glucose and a positive test can indicate a CSF leak. For definitive confirmation of a CSF leak, a beta-2 transferrin assay is advised.

Step-by-step explanation:

Following a motor vehicle accident, if clear fluid is running out of a patient's nose and a head injury is suspected, the fluid should be tested for the presence of glucose. When a patient's cerebrospinal fluid (CSF) leaks, it may exit through the nose, a condition known as CSF rhinorrhea. The presence of glucose in this fluid is indicative of a CSF leak, as nasal secretions typically do not contain high levels of glucose. By contrast, CSF contains glucose, which can be detected using test strips or lab analysis.

A beta-2 transferrin assay is the most specific and sensitive test for the confirmation of CSF leakage, but glucose tests can be a quick initial assessment. This is because beta-2 transferrin is uniquely present in CSF and not in other bodily fluids. However, in an emergency setting where such specialized testing is not immediately available, a glucose test serves as a rapid diagnostic tool.