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Copyright 2009 Seattle/King County EMS Overview of CBT 450 Diabetic Emergencies Complete course available at www.emsonline.net.

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Presentation on theme: "Copyright 2009 Seattle/King County EMS Overview of CBT 450 Diabetic Emergencies Complete course available at www.emsonline.net."— Presentation transcript:

1 Copyright 2009 Seattle/King County EMS Overview of CBT 450 Diabetic Emergencies Complete course available at www.emsonline.net

2 Copyright 2009 Seattle/King County EMS Introduction Diabetic Emergencies Diabetes affects 20.8 million people At least one-third of people with diabetes are unaware they have the disease

3 Copyright 2009 Seattle/King County EMS Practical Skills Patient assessment Blood glucometry Oral glucose To receive CBT or OTEP credit, you must perform the following practical skills:

4 Copyright 2009 Seattle/King County EMS Terms acidosis — Excessive acid in the body fluids. glucagon — A hormone produced by the pancreas that causes the liver to convert stored glycogen into glucose and release it into the bloodstream. The action of glucagon is opposite that of insulin. hyperosmolar nonketotic coma — A complication of type 2 diabetes that results in extremely high glucose levels without the presence of ketones. ketones — Acids that are the product of fat metabolism.

5 Copyright 2009 Seattle/King County EMS Terms, continued polydipsia — Excessive thirst persisting for long periods of time despite reasonable fluid intake; often the result of excessive urination. polyphagia — Excessive eating; in diabetes, the inability to use glucose properly can cause a sense of hunger. polyuria — The passage of an unusually large volume of urine in a given period.

6 Copyright 2009 Seattle/King County EMS Glucose Glucose, a form of sugar, is body’s main source of energy

7 Copyright 2009 Seattle/King County EMS Insulin A hormone produced by pancreas Helps glucose enter cells and produce energy

8 Copyright 2009 Seattle/King County EMS Types of Diabetes Type 1 diabetes - body does not produce insulin so glucose cannot enter cells

9 Copyright 2009 Seattle/King County EMS Types of Diabetes, continued Type 2 diabetes - body does not produce enough insulin or cells ignore insulin produced

10 Copyright 2009 Seattle/King County EMS Hypoglycemia Too much insulin, too little food or too much exercise

11 Copyright 2009 Seattle/King County EMS Hypoglycemia, continued Medical history Insufficient food intake Excessive insulin dosage Normal to excessive activity Rapid onset Absent thirst Intense hunger Headache Seizures Recent illness, change in diet

12 Copyright 2009 Seattle/King County EMS Hyperglycemia Too little insulin, not enough exercise or too much food

13 Copyright 2009 Seattle/King County EMS Hyperglycemia, continued Medical history Recent infection Three Ps (polyphagia, polydipsisa, polyurea) Vomiting, abdominal pain Flu-like symptoms, nausea Insufficient insulin dosage Gradual onset Normal activity level

14 Copyright 2009 Seattle/King County EMS Hypo Vs. Hyper Insufficient food intake Pale, moist skin Rapid onset Weak, rapid pulse Low BP Low blood glucose Insufficient insulin Warm, dry skin Gradual onset Rapid, deep respirations Intense thirst Increased urination High blood glucose

15 Copyright 2009 Seattle/King County EMS Insulin Reaction Cold, pale, clammy skin Abnormal, hostile, bizarre behavior (appears intoxicated) Shaking, trembling, weakness Full, rapid pulse Normal or elevated blood pressure Dizziness, headache, blurred vision Extreme hunger Seizures Loss of consciousness

16 Copyright 2009 Seattle/King County EMS Diabetic Ketoacidosis High blood glucose levels The Three P’s Altered LOC (advanced DKA)

17 Copyright 2009 Seattle/King County EMS Diabetic Coma Unconsciousness from severe hypoglycemia, diabetic ketoacidosis or hyperglycemia combined with profound dehydration

18 Copyright 2009 Seattle/King County EMS Patient History When did you eat last? How much did you eat? Have you taken your insulin today? Has there been a change in your health, stress or exercise level? When did the symptoms begin?

19 Copyright 2009 Seattle/King County EMS Glucometry 1.Don gloves and eye protection. 2.Clean fingertip with an alcohol pad. 3.Grasp finger near area to be pricked and squeeze. 4.Prick side of finger with a sterile lancet and squeeze finger gently. 5.Place drop of blood on the test strip. 6.Read meter and record reading and time.

20 Copyright 2009 Seattle/King County EMS Care for Diabetic Emergency Request medic unit, if indicated Maintain airway Administer oxygen If able to swallow, give oral glucose Monitor vital signs and LOC

21 Copyright 2009 Seattle/King County EMS Oral Glucose Ask patient if able to swallow, if not don’t administer Position upright Ask patient to sip or chew sugar-containing substance Monitor patient’s response to glucose Repeat blood glucometry

22 Copyright 2009 Seattle/King County EMS Swallow Reflex Ability to swallow is an effective indicator of the ability to maintain an airway If patient can’t swallow don’t give oral glucose

23 Copyright 2009 Seattle/King County EMS Summary Type 1 diabetes - body does not produce insulin Type 2 diabetes - body does not produce enough insulin or cells ignore insulin produced

24 Copyright 2009 Seattle/King County EMS Summary, continued Hypoglycemia - too much insulin, too little food intake or too much exercise Hyperglycemia - too little insulin, not enough exercise or too much food

25 Copyright 2009 Seattle/King County EMS Summary, continued Medical history suggesting hypoglycemia Insufficient food intake Excessive insulin dosage Normal to excessive activity Rapid onset Absent thirst Intense hunger Headache, seizures

26 Copyright 2009 Seattle/King County EMS Summary, continued Medical history suggesting hyperglycemia Recent infection The Three P’s Vomiting, abdominal pain Flu-like symptoms, nausea Insufficient insulin dosage Gradual onset Normal activity level

27 Copyright 2009 Seattle/King County EMS Summary, continued Treatment for hypoglycemia Request medic unit, if indicated Maintain airway Administer oxygen If able to swallow, give oral glucose Monitor vital signs and LOC

28 Copyright 2009 Seattle/King County EMS Summary, continued Your primary responsibility for a hyperglycemic diabetic is to maintain the airway and provide rapid transport Guidelines for administering oral glucose Ask if able to swallow, if not don’t administer Position upright Ask to sip or chew sugar-containing substance Monitor patient’s response Repeat blood glucometry

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