Answer: Great question. Clearly many/most patients who have suffered major trauma and have an altered LOC most likely are suffering from a traumatic brain injury and not hypoglycemia as you correctly point out. That being said, the comprehensive assessment of any patient with an altered LOC would be to obtain a blood glucose determination as soon as feasible/practical given the circumstances. One never knows, the patient on the bike could have swerved into traffic related to their hypoglycemia/confusion and then sustained the traumatic injury.