Chapter 19 Diabetic emergencies (sepsis)

Question 1

hypoglycemia

Answer 1

low blood sugar, is the most common diabetic emergency. it can be caused by many things

• taking too much insulin
• reduces sugar intake (not eating)
• overexercises (over exertion) burning more sugar than normal
• vomits a meal, emptying the stomach of sugars as well as other nutrients
• increases metabolic rate in conditions such as fever or shivering

-very fast onset

can appear intoxicated

Question 2

brain cells and other cells starve when______?

Answer 2

blood sugar is low

Question 3

the body responds to hypoglycemia by_____?

Answer 3

signaling to the liver to release glycogen (stored glucose) to increase the blood sugar level.

signs of this are:

• pale skin
• tachycardia
• rapid breathing

Question 4

hyperglycemia

Answer 4

when there is a decrease in insulin. which leaves blood sugar in the bloodstream.

• decreases in insulin can range from forgetting to take insulin shot, to stress or increase of dietary intake.
• occurs over days (not a rapid onset)

can appear intoxicated

Question 5

diabetic ketoacidosis

Answer 5

result of high blood sugar (hyperglycemia) characterized by:

• dehydration
• altered mental status
• shock

Signs:
rapid breathing
ketone breath (as the body is trying to rid itself of these by products)

Question 6

glucose meters

Answer 6

advances in managing diabetes is having a portable device to monitor insulin levels regularly.

-if a patient has a meter, you as the EMT can have a family member complete a reading to get a baseline blood sugar level.

we should never use a patients glucose meter

Question 7

mild hypoglycemia

Answer 7

most of the time this can be treated by just giving the patient something to eat.

preferably a little simple sugars, and some complex sugars so it can last longer than an hour

Question 8

oral glucose

Answer 8

only able to be administered if the patient is aware and able to swallow and protect their airway

Question 9

other causes of altered mental status

Answer 9

hypoxia
drug & alcohol
brain injuries
traumatic and medical brain injury

Question 10

“glucose for everyone”

Answer 10

the rule of thumb that regardless of hypoglycemia or hyperglycemia, administer glucose when possible.

Question 11

alcoholic diabetic

Answer 11

often is a good candidate for diabetic emergencies. due to the fact that he tends to neglect eating and taking insulin during prolonged drinking.

Question 12

sepsis

Answer 12

simply an infection
-sepsis is one of the most dangerous causes of altered mental status.

-normally referring to a more severe collection of infections system wide. once infections move from a localized site to a body wide infection

Question 13

sepsis caused shock 2 types

Answer 13

• distributive shock vasodilation that once helped move white blood cells is now causing a severe drop in blood pressure.
• hypovolemic shock the process of diluting toxins from the bloodstream now results in a massive fluid shift out of the cardiovascular system. causing hypovolemic shock

the body can release toxins that can further harm the cardio system

Question 14

evidence of possible sepsis

Answer 14

altered mental status
increased heart rate
increased respiratory rate
low blood pressure
high blood glucose levels
decreased capillary refill time