Diabetes – What is it?

Hormone (insulin) needed to regulate blood glucose levels is ineffective;

Glucose levels can get too high or too low

Type I - patients do not produce insulin at all, need daily injections

typically strikes children, but also adults patients more likely to suffer organ damage - eg blindness, heart disease, kidney failure

Type II – patients have inadequate or ineffective insulin usually controlled with diet, exercise, drugs

Diabetes – What is it?

Diabetes – Hypoglycemia

Causes - too much insulin, - not enough food,

- excessive exercise, - has been ill,

- overdose of oral medication (special problem with kids)

S&S: What do you see - develops quickly (perhaps minutes) - altered level of consciousness - hungry; NO thirst or nausea

- Progression = fainting, shock, seizure, coma classic shock signs – form of Metabolic Shock

pale/clammy skin, rapid pulse, rapid respirations

Low blood sugar – all glucose taken out

Diabetes – Hyperglycemia High blood sugar – cells starved for glucose

Causes - insufficient insulin - markedly overeats, - undergoing stress (infection,

illness, overexertion, alcohol)

S&S: What do you see

- develops slowly (hours to days) - rapid & deep respirations (kassmaul) and

sweet, fruity breath - dehydration (dry, warm skin &

sunken eyes - very thirsty, excessive urination,

nausea - restless merging to coma

Diabetes – What can you do? Most diabetics understand and manage their disease well.

Care for the Diabetic

– If unresponsive = monitor airway, administer high flow O2, call for emergency transport

– If responsive• Get medical history, look for medic alert tags

USE THE 6th ALWAYS QUESTION!

• Give glucose orally if can swallow, even if not sure hypoglycemic

• Feed a recovered hypoglycemic patient

– If patient does not respond to glucose = Rapid Transport

Diabetics can have a ‘silent” or painless heart attack

Diabetes – Administering Glucose

Effects should be seen very quickly if hypoglycemic

Substance Abuse – What do you see?Signs and Symptoms vary with category of drug taken

CNS Depressants – depress all autonomic functions General S&S: hypoventilation, hypotension, sedation or coma

– Sedatives - eg valium, seconal (+ slurred speech)– Inhalants – eg glue, acetone (+ seizure)– Narcotics/Opiods – eg heroin, oxycodon, morphine, vicodin

(+ constricted pupils)– Alcohol & Marijuana

CNS Stimulants – either stimulate sympathetic or block parasympathetic

General S&S: dilated pupils, hypertension, tachycardia, agitation or seizures, hypothermia– Class 1 – eg cocaine, amphetamines– Class 2 - eg atropine (+ dry skin & mucus membranes) increases

heart rate; can be administered variety of ways– Hallucinogens – eg LSD

Substance Abuse – What can you do?ABC -> Maintain airway, Administer O2, assist ventilations

if necessary

-> Watch for seizures, vomiting -> Preserve vomit, bottles, pills, etc and send with patient to

hospital

If unresponsive, – Place in recovery position, – Treat for shock, – Transport ASAP

If responsive– Calm if agitated; do not try to restrain– Find out (i) what was taken, (ii) when taken, (iii) how much,

(iv) any actions taken, and (v) how much weigh– Transport ASAP

=> Do Not Leave Alone <=