Chapter 19 Diabetic Emergencies and Altered Mental Status

Question 1

Key Terms

a sensation experienced by a seizure patient right before the seizure, which might be a small, sound, or general feeling

Answer 1

Aura

Question 2

Key Terms

also called “sugar diabetes” or just “diabetes,” the condition brought about by decreased insulin production or the inability of the body cells to use insulin properly. The person with this condition is a diabetic

Answer 2

Diabetes Mellitus

Question 3

Key Terms

a condition that occurs as the result of high blood sugar (hyperglycemia), characterized by dehydration, altered mental status, and shock

Answer 3

Diabetic Ketoacidosis (DKA)

Question 4

Key Terms

a medical condition that causes seizures

Answer 4

Epilepsy

Question 5

Key Terms

a seizure that affects both sides of the brain

Answer 5

Generalized Seizure

Question 6

Key Terms

a form of sugar, the body’s basic source of energy

Answer 6

Glucose

Question 7

Key Terms

high blood sugar

Answer 7

Hyperglycemia

Question 8

Key Terms

low blood sugar

Answer 8

Hypoglycemia

Question 9

Key Terms

a hormone produced by the pancreas or taken as a medication by many diabetics

Answer 9

Insulin

Question 10

Key Terms

a seizure that affects only one part or one side of the brain

Answer 10

Partial Seizure

Question 11

Key Terms

the period of time immediately following a tonic-clonic seizure in which the patient goes from full loss of consciousness to full mental status

Answer 11

Postictal Phase

Question 12

Key Terms

series of neurologic circuits in the brain that control the functions of staying awake, paying attention, and sleeping

Answer 12

Reticular Activating System (RAS)

Question 13

Key Terms

a sudden change in sensation, behavior, or movement. The most severe form of seizure produces violent muscle contractions called convulsions

Answer 13

Seizure

Question 14

Key Terms

infection, especially a severe, systemwide response to infection

Answer 14

Sepsis

Question 15

Key Terms

a prolonged seizure or situation when a person suffers two or more convulsive seizures without regaining full consciousness

Answer 15

Status Epilepticus

Question 16

Key Terms

a condition of altered function caused when an artery in the brain is blocked or ruptured, disrupting the supply of oxygenated blood or causing bleeding into the brain. Formerly called a “Cerebrovascular Accident (CVA)”

Answer 16

Stroke

Question 17

Key Terms

fainting

Answer 17

Syncope

Question 18

Key Terms

a generalized seizure in which the patient loses consciousness and has jerking movements of paired muscle groups

Answer 18

Tonic-clonic

Question 19

Short Answer

List the chief signs and symptoms of a diabetic emergency.

Answer 19

Signs of a diabetic emergency include altered mental status, seizures, pale skin, diaphoresis, tachycardia, rapid breathing, frequent urination, and increased thirst.

Question 20

Short Answer

Explain how you can determine a medical history of diabetes.

Answer 20

A history of diabetes can most easily be obtained by questioning the patient, family, or other bystanders. Other indicators include MedicAlert bracelets; medications such as insulin or oral antidiabetics; and the presence of syringes, glucose meters, and/or an insulin pump.

Question 21

Short Answer

Explain what treatment may be given by an EMT for a diabetic emergency and the criteria for giving it.

Answer 21

After assuring scene safety, treatment of a diabetic emergency must include a thorough assessment. Treat immediate life threats such as airway or breathing issues, and attempt to determine if the emergency is the result of hyper- or hypoglycemia (if possible). If you cannot make this determination, or if the patient is hypoglycemic, consider administering oral glucose (if it can be done safely and appropriately). Oral glucose will replenish absent sugar stores in the bloodstream and potentially reverse hypoglycemia.

Question 22

Short Answer

Tell whether treatment for a diabetic emergency should be given before or after baseline vital signs are taken.

Answer 22

Unless local protocols dictate otherwise, baseline vitals should be obtained prior to administration of any medication.

Question 23

Short Answer

Explain the care that should be given to a patient who has had a seizure.

Answer 23

Treatment of a seizure patient should include protecting him from trauma related to the seizure, airway and breathing support if necessary, supplemental oxygen, and a thorough assessment to possibly identify the cause of the seizure.

Question 24

Short Answer

Explain the care that should be given to a conscious and to an unconscious patient with suspected stroke.

Answer 24

For either a conscious or an unconscious stroke patient, conduct a thorough assessment that includes identification of when the stroke began. Care for a conscious stroke patient should include reassuring the patient, monitoring the airway, and administering high-concentration oxygen. Transport the conscious stroke patient in a semi-sitting position. Care for an unconscious stroke patient should include maintaining an open airway and providing high concentration oxygen. For transport, the unconscious stroke patient should be positioned lying on the affected side. Transport any stroke patient to a hospital with the capabilities to manage a stroke patient or as guided by local stroke care protocols.

Question 25

Short Answer

Explain the care that should be given to a patient who has experienced dizziness or syncope.

Answer 25

Care for dizziness and/or syncope should include supplemental oxygen, a request for ALS assistance, laying the patient flat, and loosening tight clothing.