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 – 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
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 <=