Hyperglycemia

Question 1

Symptomatic hyperglycemia is defined as a BGL of > ___ with signs of severe _____, _______, and _____.

Answer 1

300; dehydration, altered mental status, shock

Question 2

Hyperglycemia is usually the result of _______________.

Answer 2

an inadequate supply of insulin to meet the body’s needs.

Question 3

______ production occurs when the body loses its ability to utilize _____ as its main source of fuel for metabolism.

Answer 3

Ketone, glucose

Question 4

In DKA or HHS patients pre hospital treatment should be focused around:

Answer 4

treatment of severe dehydration and support of vital functions.

Question 5

What are the signs and symptoms of hyperglycemia?

Answer 5

anxiety/agitation/confusion, dry/red/warm skin, acetone (fruity) smell on breath, kussmaul respirations, dry mouth, intense thirst, abnormal/hostile behavior, tachycardia, dizzness / headache.

Question 6

Describe Kussmaul respirations.

Answer 6

Deep, labored, gasping respirations from prolonged metabolic acidosis.

Question 7

What are the 6 parts to the EMT-B part of this protocol?

Answer 7

Perform initial assessment, assess for signs of trauma, pulse oximetry, suction if needed, consider possible causes for AMS, obtain a blood glucose sample.

Question 8

What are the 8 parts to the Paramedic part of this protocol?

Answer 8

Cardiac monitor, establish IV, if BGL is higher than 300 w/ signs and symptoms of dehydration then administer normal saline infusion, apply nasal capnography, obtain and interpret 12 lead, transport, reassess BGL on arrival of facility.

Question 9

What is the rate of your normal saline infusion in this protocol?

Answer 9

10mg/kg over 1 hour.

Question 10

When administering normal saline infusion what conditions should you ask about and how should you proceed if conditions present?

Answer 10

CHF or renal failure, you should reassess after 250 mL for signs of fluid overload.

Question 11

On RAA’s current glucometer a reading of “HI” means:

Answer 11

the BGL is greater than 600

Question 12

As DKA increases it depletes the body’s _______ reserves due to prolonged and increasing _______, thus significantly decreasing ________.

Answer 12

bicarbonate, acidosis, carbon dioxide

Question 13

We can expect metabolic acidosis and DKA when:

Answer 13

the patient’s BGL is above 250 and the PetCO2 is 29 or below in the absence of Kussmaul breathing. The body’s bicarbonate reserve has depleted to an unacceptable level.

Question 14

Early signs and symptoms include:

Answer 14

tachycardia, pale gums, and dry mucous membranes.