Diabetic Emergencies

Question 1

Diabetes

Answer 1

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

Question 2

What is the cause of diabetes

Answer 2

Caused by the pancreas not producing enough insulin or the body’s cells not responding properly to the insulin produced.

Question 3

Type 1 Diabetes

Answer 3

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

Question 4

Type 2 Diabetes

Answer 4

Most common diabetes

Cause: Excessive body weight and lack of exercise

Treatments: Blood pressure management, insulin sensitizers

Question 5

Gestational Diabetes

Answer 5

a condition that occurs when a person without diabetes develops high blood sugar levels during pregnancy.

Question 6

Hypoglycemia

Answer 6

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,

Question 7

EMS Protocol for Diabetic Emergencies

Answer 7

1. Perform initial patient assessment. Look for medical alert tags.
2. 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
3. Administer oxygen.
4. 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.
5. 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.
6. Repeat testing of blood sugar in 15-20 minutes. REPORT TO MEDICAL CONTROL. Glucagon may be repeated in 20 minutes with physician authorization.
7. Transport. Consider ALS intercept for hypoglycemic patients unresponsive to initial treatment.

Question 8

Glucagon injections

Answer 8

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

Question 9

Diabetic Ketoacidosis

Answer 9

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

Question 10

Hyperglycemia

Answer 10

High blood sugar

Represented by blood glucose levels of approximately 250mg/dL or higher

Symptoms: blurred vision, polyuria, polydipsia, or polyphagia

Question 11

The Tree P’s

Answer 11

Three common symptoms of diabetes

Polyuria: Increased urination
Polydipsia: Increased thirst
Polyphagia: Increased appetite

Question 12

What is the treatment for hyperglycemia

Answer 12

Fluids and insulin

1 to 1.5 L of normal saline should be given within the first hour

Question 13

Hyperosmolar Hyperglycemic Nonketotic Coma (HHNC)

Answer 13

Result of elevated glucose levels in patients with type 2 diabetes reaching a max of 600 mg/dl

Question 14

What are some prescription drugs for type 1 diabeties

Answer 14

Short acting drugs: Lispro, Aspart, Glulisine
Long-acting insulins: Glargine, Detemir

Question 15

What are some prescription drugs for type 1 diabeties

Answer 15

Metformin, Actos, Glucophage, Glipizide

Question 16

Ketoacidosis

Answer 16

Condition where fat metabolization due to no glucose produces acids called ketones that poison the body by changing the pH balance

Question 17

Insulin shock

Answer 17

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

Question 18

What are the signs of Diabetic Ketoacidosis

Answer 18

• High blood glucose levels
• The Three P’s (frequent urination, dehydration and extreme thirst)
• Altered LOC
• Fruity odor on patient’s breath

Question 19

Events that cause DKA

Answer 19

• Infection
• Missed insulin injection
• Heart attack, stroke, trauma, stress or surgery

Question 20

Blood glucometery

Answer 20

Effective tool for determining if a case of altered mental status is diabetes related

Question 21

Key principles of hypoglycemic episode treatment

Answer 21

• Request medic unit
• Maintain airway
• Administer oxygen
• Give oral glucose if can swallow
• Monitor vital signs and LOC

Question 22

Insulin

Answer 22

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.

Question 23

What is the function of insulin?

Answer 23

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.