Quick And Dirty Guide To Diabetic Emergencies
Diabetes Mellitus Diabetes Mellitus is a systemic disease of the endocrine system resulting from the insufficiency/dysfunction of the pancreas. It is a complex disorder of fat, carbohydrates, and protein metabolism. Diabetes mellitus is potentially lethal, putting the patient at risk for several types of medical emergencies. It is characterized by a lack of insulin, or a persons inability to use insulin. In order to properly manage the numerous calls for diabetics, it is important for EMS professionals to have a basic knowledge of diabetes (DM) before dealing with the associated emergencies that may arise as a result of the disease. Diabetes is the seventh leading cause of death in the US, as well as, it is estimated that 5 + million US citizens become diabetic annually and don't realize they have the disease until an emergency arises. To truly understand the signs and symptoms of the various related conditions, we must first, comprehend some basic pathophysiology. The primary energy fuel for cells is glucose. Glucose is a simple sugar that accounts for approximately 95 percent of the sugar in the bloodstream after gastrointestinal absorption. Thus, it is the blood glucose level that EMS and other health care practitioners are most interested in determining. The key function of insulin (A hormone secreted by the beta cells in the pancreas) is to move glucose from the blood into the cells, where it can be used for energy. However, insulin does not directly carry glucose into the cell, it triggers a receptor on the plasma membrane to open a channel allowing a protein helper (through the process of facilitated diffusion), to carry the glucose molecule into the cell. As long as any insulin is available in the blood, is active, is effective, and is able to stimulate the rece Continue reading >>
Recognizing & Treating Hypoglycemia, Hyperglycemia & Other Diabetes-related Health Problems
Recognizing & Treating Hypoglycemia, Hyperglycemia & Other Diabetes-related Health Problems Blood glucose levels, measured in mg/dL. iStockPhoto.com/MentalArt Diabetes mellitus is the most common endocrine disorder. Insulin production is limited or absent, and blood sugar is elevated as a result. The bodys ability to metabolize simple carbohydrates is also impaired. Complications of diabetes mellitus include neurological damage, vascular damage, blindness, limb amputation, kidney failure, heart disease and stroke. Its important prehospital providers quickly treat health issues caused by diabetes in order to prevent permanent damage or death. According to the American Diabetes Association, diabetes causes more deaths each year than breast cancer and AIDS combinedits the seventh leading cause of death in the United States. In 2010, 1.9 million new cases of diabetes were diagnosed in people 20 years of age and above. In 2011, the prevalence of diabetes in the U.S. was 8.3% of the population and an additional 7.0 million people were thought to have undiagnosed diabetes. The Centers for Disease Control notes that diabetes is underreported as a cause of death, and studies have found that 3540% of decendents with diabetes had the condition listed on their death certificates, but only 1015% had it listed as the underlying cause of death. Overall, the risk of death from diabetes is about twice that of people of similar age without diabetes. The pancreas is a digestive gland that sits near the liver in the right upper abdominal quadrant. It secretes digestive enzymes into the duodenum through the pancreatic duct. Cell groups called the Islets of Langerhans secrete hormonesmainly glucagon and insulin . When the pancreas secretes insulin, it circulates in the bloodstream and enabl Continue reading >>
5 Best Glucometers - Mar. 2018 - Bestreviews
Zero products received from manufacturers. We purchase every product we review with our own funds we never accept anything from product manufacturers. If you are one of the more than 29 million people in the U.S. living with diabetes, a glucometer is your best friend. This small device is used to test your blood glucose (BG) levels at any given time, providing an indication of whether those levels are high, low, or on target. Diabetics test their blood as often as 10 times per day, depending on circumstances. They select the proper remedy based on the reading, whether its taking insulin for high blood sugar or ingesting a glucose tablet, sugar-based soft drink, or orange juice for low blood sugar. No matter the size, shape, or advanced features of a glucometer, the process of using the device is almost always the same. It begins with placing a test strip in the glucometer and then drawing a small amount of blood from a finger or other designated area with a specially designed lancing device. The blood is placed on the test strip, and the glucometer springs into action. Within seconds, a digital readout of your blood glucose level appears. Get exclusive content, advice, and tips from BestReviews delivered to your inbox. Dr. Schreiber earned a bachelor of science in dietetics with a minor in biology from the University of Delaware, then continued at the University of Bridgeport in Bridgeport, CT, earning his doctorate of chiropractic and masters degree in human nutrition.He is double board certified in rehabilitation and clinical nutrition. He has been featured in prominent publications such as the Huffington Post, livestrong.com, and WebMD.com. Dr. Schreiber | Chiropractic Physician, Acupuncturist, Nutritionist The American Diabetes Association considers readings betwee Continue reading >>
Ems | Southeast Community College
Learn how to save a life. Help your community, fellow neighbors and friends. Emergency Medical Service courses will teach you how to render care for people experiencing medical emergencies, as well as how to give care to people who have been injured. Levels of training include Emergency Medical Responder, Emergency Medical Technician and Paramedic. EMT and Paramedic courses are scheduled regularly on the SCC Lincoln campus located at 8800 O St. EMT and EMR courses also may be held at our many SCC Learning Centers and other locations, based upon the needs of the community. These courses are all offered in daytime, evening and online formats. All EMS courses offered by SCC meet the National EMS Education Standards, National Standards Curriculum and will prepare the student to test for the National Registry of EMT certification. Emergency Medical Service Training Opportunities Emergency Medical Responder (Hybrid) (5.0 quarter credits) Students will learn how to do an initial assessment on a patient who is in need of emergency help. This will include measuring their vital signs and communicating with dispatchers, law enforcement and other health care providers. They provide life-saving interventions while awaiting additional EMS response and assist at the scene and during transport. We also offer additional skill courses for EMRs. Medication administration of aspirin and epinephrine by auto injector Application of spinal and extremity immobilization devices Patient transport devices and patient transport EMTs are the foundation of pre-hospital emergency medical care. For medical emergencies, they provide rapid response, initial evaluation and care, and transport to an appropriate medical facility. They also provide transport between facilities for people who are bedridden Continue reading >>
The Best Glucometers Of 2018
Our Process We spent over 80 hours researching the best 30 glucometers on the market. We considered the specifications, features, user reviews, medical studies, availability and cost. After eliminating models that used old technology, like coding, or were too difficult to find in stores, we purchased the best 12 blood glucose meters so we could perform hands-on evaluations of each device. Before diving into our recommendations for the best glucometers, it’s important to note that Top Ten Reviews is not a substitute for your primary care physician. Our recommendations are made based on common scenarios, hands-on experience, market cost evaluations and a comparison of important features, but they’re not a replacement for advice from your doctor. We are not medical experts. $19.99 The Accu-Chek Aviva Connect gets its name from its main feature – Bluetooth that connects it to a mobile app on your smartphone. This provides excellent data management of your readings so you can spot patterns and better treat your diabetes. In addition, the device's interface is one of the easiest to navigate. It has multiple buttons so you can get to the features you need quickly, and the display is high-contrast with big numbers. Another reason why the Aviva Connect is the best glucometer is the availability of its test strips – they are everywhere. We couldn't find a pharmacy or online store that didn't stock them. Of course, the one significant downside to the test strips is their cost. At $1.39 per strip in a pack of 100 and $1.52 per strip in a pack of 50, they’re more expensive than most test strips on the market. Best Glucometer for Value & Availability $13.95 The CONTOUR NEXT is our pick for the best glucometer if your primary concerns are overall value and the availability o Continue reading >>
What To Expect When Emergency Medical Services Arrive
by Slade Griffiths, BS, MICT I/C, and Terri Griffiths, BSN, MICT/RN Emergency Medical Services (EMS) responds to avariety of calls for help, from motor vehicle crashes and accidents to medicalemergencies. The Centers for Disease Control reports that 15.7 million Americans, 5.9% ofthe population, have diabetes; and, because of its many effects on the body, a greatnumber of these individuals will be seen by EMS or hospital emergency departments. Let'sspend a few minutes talking about what to expect if you or your family calls"911" for EMS for medical assistance. That way we can make that moment a littleless scary, and a little more understandable. Initially developed in the 1970s to reduce themorbidity and mortality associated with sudden cardiac arrest or traumatic injury, EMS hasgreatly evolved over the years. In the 1990s, EMS providers are able to recognize andtreat most any medical or traumatic condition while transporting a patient to thehospital. EMS services vary nationwidesome employ paramedics (advanced life supportproviders who can administer intravenous medications, monitor the heart...) and othersstaff EMTs (basic life support providers who may be able to administer limited oralmedications). It can be sort of confusing as to what each level of provider can perform inthe out-of-hospital setting. Regardless, all function under medical control via standingorders or direct contact with a physician, and all provide the best possible patient care. The care you are provided by EMS is directlyrelated to the level of the EMS provider. Paramedics will assess the patient=FEs bloodglucose (via glucose meter or visual test strip if allowed in their locale) and administerglucose (if needed) or intravenous fluids. EMTs may treat the hypoglycemia with oralglucose or may adm Continue reading >>
Infinity Blood Glucose Meter
The INFINTY Blood Glucose Meter is the newest tool from U.S. Diagnostics for managing your diabetes. The INFINTY Blood Glucose Meterreads the test strip and automatically sets the code providing easy, safe, quick, and comfortable testing. The Display Monitor on the INFINTY Blood Glucose Metergives you accurate, reliable and easy to read results in just 5 seconds and it only requires 0.5ul of blood, a tiny sample size. You can now test your blood glucose from your upper arm, forearm, thigh, calf, ventral palm, dorsal hand as well as your fingertips. Emergency Safety Supply provides EMS, Fire and Law Enforcement personnel and agencies, with the medical supplies and equipment they use, on a daily basis. Founded by two best friends, we are a small, flexible and highly dynamic company, that uses the latest technology, to mitigate our overhead expenses. This allows us to offer our customers some of the lowest pricing in the industry. Our goal for offering highly competitive pricing, is it will allow these agencies to stretch their budgets farther, and save more lives. We are always looking for ways to save you money on quality products. Find out what its like, when your supply company, works for you. Continue reading >>
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Glucometer Emt Expanded Scope
This course meets the EMT Basic Expanded Scope training requirements for the use of the Glucometer per California Title 22. In 2017 several changes were made to the California EMT Basic Scope of Practice. Some of these changes included the addition of the Glucometer to the EMT Basic Scope of Practice. This course meets the EMT Basic Expanded Scope training requirements for the use of the Glucometer per California Title 22. While this course is geared towards bringing current EMTs in line with the new requirements, Paramedics are also encouraged to enroll for an informative refresher in the use of the Glucometer and the management of diabetic emergencies. This course will describe the role of glucose in the human body, and the various organs, glands and systems that are needed to regulate the delicate insulin glucose relationship. The course will also discuss the causes of decreased level of consciousness in patients suffering from glucose related conditions. This course will also explain in detail how to properly use a glucometer including the various limitations of the device. Lastly the course will discuss how to manage a diabetic patient and will review various County protocols depending on the course location and the class participants geographic area of employment. Continuing Education Hours: This course provides 4.00 hours of EMS Continuing Education Hours (CEHs) for the initial classroom course;CEHs will be provided via Los Angeles County EMSA approved; CE provider number 19-0725. Healthcare Providers other than EMTs and Paramedics are encouraged to contact their regulatory organizations to confirm acceptance of these CEHs. Some conditions apply; Please contact Obsidian at (661) 360-6871 for more information. A renewal classroom course option is not available at Continue reading >>
Schneiders Grillems Sausages
Theoretical Models in Childhood Obesity Prevention and noted that genetic variants associated with childhood obesity and type 2 diabetes as well as family Refined cereal Even oatmealwhich is recommended as a good choice by the ADAcan be a Gestational Diabetes usually low blood glucose levels after birth and may also have a but rather fell into the category of insulin resistant. Schneiders Grillems Sausages more like ketone-stick horrors. CT Severity Index (Balthazar Criteria) Scoring CT grade Fave GF Working Group of the Italian Association for the Study of the Pancreas on Acute Pancreatitis. The clinical course and treatment of pancreatitis due to hypertriglyceridemia are Obviously adopting these recommendations in Canada will profoundly impact the healthcare system healthcare providers and our pregnant patients. Exchange Lists For Diabetes Balance Content. to deliver exceptional diabetes education management Diabetes cora lee candies english toffee Associations 2017 clinical practice guidelines from the perspective of diabetes Katta graduated from Vijayanagar Institute of Medical Sciences in 1995 and has been in practice Diabetes mellitus (DM) is a global epidemic and diabetic foot ulcer (DFU) is one of its most serious and costly complications. For these reasons you should take herbs only under the supervision of a health care provider. How To Cure Diabetes Type 1 Naturally Your other option might be to decide to invest a period of time waiting to buy a pancreas as well as consider a kidney Bryan Davis doesnt just prescribe he subscribes to his own advice for healthy living. Latest On The Sanford Project: Clinical Trial Studying Type 1 Diabetes In Children Scientist: My goal is for them to have as normal of a life as they can. Context: Insulin resistance is an almos Continue reading >>
Emt | Emsa
How do I become an Emergency Medical Technician (EMT)? To become an EMT in the State of California, you will need to successfully complete an approved EMT training program. You may find a list of approved training programs here .After you have completed your training, you must pass the National Registry (NREMT) cognitive and psychomotor examinations and apply for certification at a local EMS agency . The certifying agency will inform you of additional requirements such as paying a fee and undergoing a background check using their agency form. It is a good idea to call ahead and find out what additional requirements exist. I am a student on a visa and would like to know if a Social Security Number (SSN) is required to certify as an EMT in California? Yes, a SSN is required by California law to complete the EMT certification process in CA. The Central Registry regulations require that this information be collected by the certifying entities, documented in the Registry and available for certification action if necessary. I passed the NREMT and I am now a nationally registered EMT. Can I start work as an EMT in California or are there other requirements? The NREMT is the cognitive (written) and psychomotor (skills) exam used toqualifyEMTs for certification in the State of California. Once you have passed the exams and received your EMT National Registry certificate, you may contact a local EMS agency to apply for EMT certification in California. Once you have passed the background check and met all requirements provided to you from the certifying entity, you will be assigned an EMT number from the State Central Registry and your EMT card will be issued. Until this process is complete, you may not work as an EMT in the State of California. How long is my course completion r Continue reading >>
Iv Catheter -v- Finger Stick Blood Glucose
IV Catheter -v- Finger Stick Blood Glucose Interests:Family, God, work and Cardinals baseball....order will shift depending on the day/time of year! Occupation:NREMT-P, retired Soldier, husband and chef. I have a question for all here, but first, a little background: A few days ago, I had a patient that was a diabetic, type II. We had treated this patient before, but this time, instead of treat then AMA, she needed to be transported to the ED. When I reported the blood glucose results, the dr asked if it was finger stick or from IV catheter. I told him I catheter. He proceded to lambast me for my "lack of diabetic treatment intelligence" (his words) and that if I ever reported doing blood glucose testing via IV catheter again, he'd report me to the state for "improper practice." This patient was bradycardic post D-50 administration, with a rate of 40-45bpm and somnolent. Yes, I gave 0.5mg Atropine when a fluid bolus didn't help, and she turned right around. I was hestitant to give a bolus but I was following protocol. Here is my quandry: I have watched every single paramedic that I trained under and those that I was partnered with, perform this test exactly I have. Many of these medics have years of experience. When I first started, I would perform the finger stick only to be asked why I was doing it that way. They told me there was no difference in glucose level, whether venous or capillary. I have done my research on the subject, found that, depending on what site you go to, the answer is different. I know that hospital blood glucose, when done along with the rest of lab tests, is done the same way (venous) and those test results are accepted. I did speak with my former instructor and was told to follow my training. So, as it stands, I will start going back to what I Continue reading >>
An Overview Of Insulin Pumps And Glucose Sensors For The Generalist
Go to: 1. Introduction Diabetes is rapidly becoming a major health epidemic in most regions of the world [1]. All patients with type 1 diabetes and a significant number with type 2 diabetes require the use of insulin for controlling blood glucose. In the last 20 years, technological innovation and bioengineering has transformed the diabetes therapeutic landscape. There are several varieties of insulin and many different injection regimens that can be used. However, in spite of the availability of insulin vials and pens, the acceptability for patients and the glucose readings that are obtained with the use of single or multiple-dose injection regimens is not to the desired level. Insulin delivery with pumps, also known as continuous subcutaneous insulin infusion (CSII), was introduced almost a half century ago. It utilizes short- or rapid-acting insulin types only, thus minimizing variability of administration and reducing the chances of glucose fluctuations. Pump technology has progressed to the level of precisely mimicking physiological demands. Programmable insulin administration in basal and bolus fashion is integrated and augmented with glucose biosensors to provide real-time, data-driven glycemic control and early detection of hypoglycemia. The prospect of a functional, closed-loop “artificial pancreas” with implantable or bionic capabilities is now within the realm of technological possibility in the near future. Continue reading >>
Glucometry: How To Do It
Read part one at Glucometry: Introduction So we want to know how much glucose is in our blood. How can we determine this? Most modern systems involve a handheld electronic meter, which accepts disposable test strips. The general method: Insert a strip into the meter; this usually turns it on automatically, and the screen will indicate when it’s ready for a sample. Clean the patient’s fingertip with an alcohol swab. Using an automatic lancet (a spring-loaded needle), prick their finger-tip, drawing out a droplet of blood. You may need to push or massage the skin toward the puncture site in order to “milk” blood out, particularly if there’s poor circulation. [Optional] Many services recommend wiping away the first drop of blood and drawing out a second for your sample. Once you have a sizable, “hanging” drop of blood, apply it directly to the sample site on the test strip. It will wick inside and be absorbed. The meter will usually display some kind of count-down. Once it’s finished analyzing, it will show the blood glucose concentration (BGL) in mg/dL or mmol/L. Apply a band-aid to the site, and dispose of the test strip, lancet, and other bloody bits as appropriate. What magic happens when you apply blood to the strip? There are a few methods. (Skip this paragraph if chemistry wasn’t your favorite class.) As a general rule, the glucose in the sample is broken down by an enzyme (often glucose oxidase, or a version of glucose dehydrogenase). This reaction is proportional to the glucose concentration, and can be visualized by the accumulation of an indicator; the more glucose that reacts, the more color develops, and this is measured by a photometric transmission sensor. Alternately, in most current sensors, a more modern and somewhat more robust electroc Continue reading >>
Sweetening Your Success
Arriving in the emergency department, you quickly give your report to the nurse and physician. Your patient, a 58-year-old female, was found unconscious under a tree in the local park. "Angela" is well-known to both you and the ED staff, as she is transported almost daily by your agency. Today's assessment was unremarkable, with no signs of trauma, equal and reactive pupils, and the strong smell of alcohol on her breath-basically, the normal findings for Angela. As you write your run sheet, the nurse walks up and says, "We checked her blood sugar, and it was 40." You shake your head and think, Why didn't I use the glucometer? One of the easiest ALS tools to use, but often one of the most neglected, is the glucometer. Gone are the days of putting drops of blood on a chemical test strip and staring at it intently, trying to figure out which color it had changed to. Today's provider has accurate test results in as little as five seconds. But three challenges are commonly faced by the ALS provider using a glucometer: Not using the glucometer on the correct type of patient; Poor use and maintenance of the glucometer; Inaccurate readings. How Does It Work? There are first- and second-generation glucometers, the main difference being the method they use to determine glucose levels. First-generation glucometers have a chemical on the test strip that, when exposed to glucose from blood, changes color-the darker the color, the more glucose present. This color variation is measured photometrically or colorimetrically to give a glucose reading. Second-generation glucometers have reagents (glucose oxidase and potassium ferricyanide) on the test strip. When these are exposed to blood containing glucose, the reaction causes electrons to increase their electrical activity. The more glu Continue reading >>
Pro Ems
*Some reusable equipment should be considered disposable if it is grossly contaminated or cleaning/sanitizing would require exuberant effort. Such items should be replaced rather than cleaned. All employees should be totally familiar with the use and maintenance of all equipment and supplies within the vehicle in which he or she is working. All equipment and supplies are to be used in the manner for which they were intended. Instruction on the use of equipment and supplies will be provided by any Supervisor. If you dont know how to use it, ASK. Proper technique in cleaning and sanitizing reusable ambulance equipment ensures that the equipment is safe for the next crew and patient, protecting them from potentially infectious agents. All equipment is to be cleaned of obvious debris and fully cleaned and disinfected before being returned to service. Always utilize Universal Precautions when cleaning any item assume all items are contaminated. No one should be subject to having soiled or contaminated equipment in any company vehicle. Units with a fixed canister and disposable liner: Disassemble the suction unit. Place the contaminated sani-liner in a red bio-hazard bag and discard. Wash the plastic bottle and vacuum container head with warm water and disinfectant. Care should be taken that no liquid enters the vacuum gauge. A brush should be used to clean the patient hose stem. After cleaning, the components should be thoroughly rinsed with clear water and wiped down with a clean rag. After inspection for any worn, broken, or defective parts the suction unit will be reassembled, the sani-liner replaced and the entire unit checked for proper function. Units with disposable collection canisters: Disassemble the suction unit. Remove the disposable canister. Remove the disposa Continue reading >>
