Diabetic Emergencies Flashcards
Diabetes
group of metabolic disorders that result in high blood sugar levels over a prolonged period of time
Includes frequent urination, excessive thirst and increased appetite
What is the cause of diabetes
Caused by the pancreas not producing enough insulin or the body’s cells not responding properly to the insulin produced.
Type 1 Diabetes
results from the failure of the pancreas to produce enough insulin due to the loss of beta cells
Usually found in children and adolescents and treated with insulin injections
Type 2 Diabetes
Most common diabetes
Cause: Excessive body weight and lack of exercise
Treatments: Blood pressure management, insulin sensitizers
Gestational Diabetes
a condition that occurs when a person without diabetes develops high blood sugar levels during pregnancy.
Hypoglycemia
Condition in which blood sugar level drops lower than normal, specifically below 70 mg/dl, patients do not show symptoms unless it is under 55 mg/dl
Needs immediate treatment through insulin or high sugar foods and drinks
Symptoms of hypoglycemia: dizziness, a fast heart rate, blurry vision, shaking, weakness, and headache, pale skin,
EMS Protocol for Diabetic Emergencies
- Perform initial patient assessment. Look for medical alert tags.
- Perform focused history and physical exam
- Determine last meal, last medication dose (including insulin type(s), number of units, time of administration, and oral hypoglycemic medications) B. Any related illness - Administer oxygen.
- Perform blood sugar reading using a glucometer.
- If blood sugar is less than 60 mg/dl and if: Patient is awake enough to protect own airway. Administer oral sugar/glucose by mouth. - CONTACT MEDICAL CONTROL. Obtain order to administer Glucagon
Adult/Child – Glucagon 1 mg. I.M.
Child less than 1 year-Glucagon 0.5 mg I.M. in anterolateral thigh. - Repeat testing of blood sugar in 15-20 minutes. REPORT TO MEDICAL CONTROL. Glucagon may be repeated in 20 minutes with physician authorization.
- Transport. Consider ALS intercept for hypoglycemic patients unresponsive to initial treatment.
Glucagon injections
an emergency treatment for severe hypoglycemia (low blood sugar) in diabetes patients who are treated with insulin and have passed out or are unable to take sugar orally
Diabetic Ketoacidosis
Life-threatening condition that happens when the blood sugar rises above 350 mg/dl due to insufficient levels of insulin
Occurs in Type 1 diabetes patients who experience stressful events when glycogen is released
Hyperglycemia
High blood sugar
Represented by blood glucose levels of approximately 250mg/dL or higher
Symptoms: blurred vision, polyuria, polydipsia, or polyphagia
The Tree P’s
Three common symptoms of diabetes
Polyuria: Increased urination
Polydipsia: Increased thirst
Polyphagia: Increased appetite
What is the treatment for hyperglycemia
Fluids and insulin
1 to 1.5 L of normal saline should be given within the first hour
Hyperosmolar Hyperglycemic Nonketotic Coma (HHNC)
Result of elevated glucose levels in patients with type 2 diabetes reaching a max of 600 mg/dl
What are some prescription drugs for type 1 diabeties
Short acting drugs: Lispro, Aspart, Glulisine
Long-acting insulins: Glargine, Detemir
What are some prescription drugs for type 1 diabeties
Metformin, Actos, Glucophage, Glipizide
Ketoacidosis
Condition where fat metabolization due to no glucose produces acids called ketones that poison the body by changing the pH balance
Insulin shock
Caused by hypoglycemia and the body reacts severely
Symptoms
- Cold, pale, clammy skin
- Abnormal or hostile, bizzare behavior
- Shaking, trembling, weakness
- Full, rapid pulse,
- Dizziness, headache, blurred vision
- Extreme hunger
- Seizures
What are the signs of Diabetic Ketoacidosis
- High blood glucose levels
- The Three P’s (frequent urination, dehydration and extreme thirst)
- Altered LOC
- Fruity odor on patient’s breath
Events that cause DKA
- Infection
- Missed insulin injection
- Heart attack, stroke, trauma, stress or surgery
Blood glucometery
Effective tool for determining if a case of altered mental status is diabetes related
Key principles of hypoglycemic episode treatment
- Request medic unit
- Maintain airway
- Administer oxygen
- Give oral glucose if can swallow
- Monitor vital signs and LOC
Insulin
Hormone released by the pancreas in response to increased levels of sugar in the body. It promotes transport and entry of sugar into muscle cells and other tissues, resulting in lower blood sugar levels.
What is the function of insulin?
Facilitate the movement of glucose across cell membranes for use as an energy source. Additionally, it moves potassium into the cell, is anabolic and blocks the breakdown of proteins and fats.
