Sudden Illness Lecture: Diabetic Emergencies

Sudden Illness Lecture Notes

• Learning Objectives (LOS): Recognize basic life support principles, identify common medical emergencies, assess and perform appropriate first aid for acutely ill patients, and rapidly assess situations at the accident scene. Analyze medical emergencies and select appropriate first aid for sudden illnesses., Work effectively in teams, communicate effectively, and act in a reliable and responsible manner while providing emergency care.

Diabetic Emergencies - Hypoglycemia

• Description: A life-threatening emergency in people with diabetes, occurring when the body doesn't receive enough sugar.
• Causes: Taking too much insulin, not eating enough, overexertion, or vomiting.
• Symptoms: Responsive but with difficulty swallowing, medical identification tag, sudden onset of symptoms, staggering, poor coordination, clumsiness, anger, bad temper, cold, pale, moist, clammy skin, confusion, disorientation, sudden hunger, excessive sweating, and trembling/shakiness.
• What to do (Rule of 15): If possible, allow the patient to check blood glucose. If testing isn't possible or blood glucose is low, give 15 grams of sugar (glucose tablets, teaspoons of sugar, 1/2 cup fruit juice). Wait 15 minutes and recheck blood glucose. If it's still low, give 15 more grams of sugar. If there is no improvement, call emergency services.
• Additional Actions (Unresponsive): Call emergency services immediately, monitor breathing, look for medical identification, Do NOT give food or drink, place the person on their side to keep the airway open, and allow fluids or vomit to drain.

Diabetic Emergencies - Hyperglycemia

• Description: A serious condition where blood sugar levels are too high, potentially resulting in diabetic ketoacidosis or hyperglycemic hyperosmolar state.
• Causes: Insufficient insulin, overeating, illness, inactivity, or stress
• Symptoms: Medical identification tag, gradual onset (hours to days), drowsiness, extreme thirst, very frequent urination, warm/red/dry skin, vomiting, fruity breath odor, heavy breathing, and eventual unresponsiveness
• What to do: Give small sips of water if the person can swallow. If unsure if it's hypo- or hyperglycemia (and the person can swallow), use the rule of 15. Do not give insulin unless the person can self-administer it. Call emergency services.

Seizures

• Description: A disturbance of electrical activity in the brain causing uncontrolled muscle movements.
• Causes: Epilepsy, head injury, brain tumor, stroke, heat stroke, poisoning (alcohol or drugs), diabetic emergency, and high fever.
• Symptoms: Sudden cry or scream, sudden loss of responsiveness, rigid body/jerky movements, arching of the back (convulsions), foaming at mouth, drooling, grinding teeth, blue lips and face, eyes rolling upward, loss of bladder or bowel control.
• What to do: Move nearby objects to avoid injuries., place something soft under the head (like a rolled towel), do not hold the person down, do not put anything in the person's mouth. Time the duration of the seizure and most seizures are less than 2 minutes. Keep bystanders away.
• When to call emergency services: Seizure lasting longer than 5 minutes, series of seizures, breathing difficulties after seizure, person has diabetes or is pregnant, seizure happened in water, first seizure, injury-related seizure, or slow recovery.

Stroke

• Description: A serious medical condition caused by a blockage in blood flow to the brain or a burst blood vessel in the brain.
• Symptoms: FAST: Facial drooping, Arm weakness, Speech difficulty, Time to seek help.
• What to do: Call emergency services immediately while waiting for help, monitor breathing, place the person on his/her back with head and shoulders raised, loosen tight clothing, prepare to turn them if needed, and if the person is unresponsive but breathing place them on their side
• Use FAST method: Face, Arms, Speech, Time

Fainting

• Description: A temporary loss of consciousness due to a reduction in blood flow to the brain .
• Symptoms: Sudden collapse, Pale skin, lips, and nail bed, Clammy, sweaty skin
• What to do: Check breathing, if no breathing – call emergency and start CPR. Keep the person flat with the head slightly elevated, if necessary, raise feet/legs and loosen tight clothing. Wipe the forehead with a cool wet cloth. If it's repeated fainting, seek medical attention.
• What NOT to do: Use ammonia inhalants, give the person anything to eat or drink before they regain consciousness, splash water on their face, or slap their face.