关键词: 意识丧失, 低血糖症, 糖尿病, 全科医生, 临床5问思维法, RICE问诊

Abstract: We reported a case of unconsciousness received by a general practitioner.The diagnostic procedure was performed with RICE（Reason-Idea-Concern-Expectation）skills，in-depth interviews，and John Murtagh's safe diagnostic strategy-a clinical 5-question thinking method was used：（1）What are the most common diseases causing unconsciousness？（2）What serious disorders must not be missed？（3）What conditions are easily missed？（4）Could the patient have a masquerading illness?（5）Is the patient's family member trying to say something? The diagnosis of hypoglycemia was performed by the evidence from a combination of medical history，physical examination and laboratory tests.The takeaway from this case is that it is important for general practitioners to obtain valid information when encountering unconscious patients.In this case，a history of taking hypoglycemic drugs was noted in the consultation，so hypoglycemia was considered first，and then the diagnosis was confirmed after a rapid examination of plasma glucose.The consultation in a general medical practice focuses not only on the disease，but also on the “person”，and the diagnosis is made based on exploring the causes thoroughly，which demonstrate a holistic diagnostic and therapeutic perspective.

Key words: Unconsciousness, Hypoglycemia, Diabetes mellitus, General practitioners, Clinical 5-question thinking method, RICE inquiring