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EMT Knowledge > Chapter 17: Endocrine and Hematologic Emergencies > Flashcards

Chapter 17: Endocrine and Hematologic Emergencies Flashcards

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1
Q

Discuss

The two types of diabetes

A

Type 1: Pt’s don’t produce insulin and need daily injections. Develops during childhood. Type 2: Pt’s produce inadequate amounts of insulin or the insulin doesn’t function effectively. These pt’s often take meds that stimulate insulin production

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2
Q

Discuss

Diabetes meds

A

Diabinese, Orinase, Micronase, Glucotrol, Glucophage, Avandia

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3
Q

Discuss

Normal blood glucose

A

80-120 mg/dL

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4
Q

Discuss

Hyperglycemia

A

>200 mg/dL. Excess glucose secreted by kidney and accompanied by water loss causing the three P’s.

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5
Q

Discuss

Three P’s of hyperglycemia

A

Polyuria: frequent/copious urination. Polydipsia: frequent drinking to satisfy thirst from polyuria. Polyphagia: Excessive eating to satisfy cell hunger.

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6
Q

Discuss

Diabetic ketoacidosis

A

DKA is a hyperglycemic crisis. Without access to sugar, body metabolizes fat, causing ketone buildup and acidosis. DKA more commonly found in type I since no insulin at all is produced. SWEET KETONE BREATH. Without insulin, progresses to unconciousness and hyperglycemic crisis and death.

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7
Q

Discuss

Kussmaul respirations

A

Deep, slow, gasping breathing that is the body’s attempt to blow off excess acid; late sign. With less severe acidosis, breathing is rapid and shallow.

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8
Q

Discuss

HHNC

A

Hyperosmolar hyperglycemic nonketotic coma. With type II diabetes, onset slower than DKA, ketone breath not present because some insulin is available. Body eliminates glucose in the urine, causing dehydration.

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9
Q

Discuss

Blood glucose levels and their meanings

A
  • 0-40: Hypoglycemic crisis
  • 40-80: hypoglycemia
  • 80-120: normal
  • 120-400: hyperglycemia
  • 400-800: DKA or HHNC
  • >800: Hyperglycemic crisis
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10
Q

Discuss

How to distinguish between hyperglycemia and hypoglycemia

A
  • Hyper vs hypo:
  • gradual vs. rapid onset.
  • PWD skin vs. PCC.
  • Thirst vs. none.
  • No hunger (usually) vs. hunger.
  • Fruity vs. not fruity breath.
  • Kussmaul respirations vs. rapid or normal.
  • Slow vs. immediate response to treatment.
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11
Q

Discuss

Hyperglycemic crisis

A

Unconsciousness from ketoacidosis, hyperglycemia, and dehydration (3 P’s)

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12
Q

Discuss

Hypoglycemic crisis

A
  • Insufficient glucose for the brain–> decrease LOC.
  • Caused by either: too much insulin, not enough food, unusual amount of activity.
  • Can result in permanent brain damage.
  • Develops MUCH MORE QUICKLY THAN HYPERGLYCEMIA
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13
Q

Discuss

Other problems/concerns associated with diabetic pt. to worry about on scene

A
  • Seizures (hypoglycemia),
  • AMS,
  • compromised airway
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14
Q

Discuss

Sickle cell disease

A

Inherited, mostly black people. Blood cells contain hemoglobin S (instead of A). Poor oxygen carriers and can cause erythrocytes to lodge in small blood vessels ore spleen (causing swelling and rupturing). Sickle cells only last 16 days (as opposed to 120 with type A). RBC’s become sickle shaped as opposed to round.

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15
Q

Discuss

Vaso-occlusive crisis

A

With sickle cell, blood flow restricted to tissue because sickle cells lodge in small vessels, causing pain, ischemia, organ damage. Lasting b/w 5-7 days

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16
Q

Discuss

Aplastic crisis

A

With sickle cell, worsening of anemia causing tachycardia, pallor, fatigue. Possibly from parvovirus P19 (stopping RBS production for 2-3 days).

17
Q

Discuss

Hemolytic crisis

A

Acute accelerated drop in hemoglobin level caused by increased erythrocyte breakdown rate

18
Q

Discuss

Splenic sequestration crisis

A

Painful acute enlargement of the spleen, causing the abdomen to become hard and bloated.

19
Q

Discuss

Thrombosis

A

Development of a blood clot

20
Q

Discuss

Thrombophilia

A

Tendency to develop blood clots. Pt’s often take blood thinners like aspirin, heparin, warfarin (Coumadin).

21
Q

Discuss

Hemophilia

A

Inability to develop clots normally. Two types: A: more common, low levels of factor VIII. B: Deficiency of factor IX.

22
Q

S/S

Hyperglycemic crisis

A
  • AMS,
  • weakness,
  • nausea,
  • emesis,
  • ab pain,
  • weak rapid pulse,
  • Kussmaul respirations to blow off excess acids,
23
Q

Discuss

Types of sickle cell crises

A
  • Vaso-occlusive
  • Aplastic
  • Hemolytic
  • Splenic sequestration
24
Q

Discuss

How long do sickle cell erythrocytes last compared to normal ones?

A

16 days vs 120

EMT Knowledge (22 decks)

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