4-4 Diabetes/altered Mental Status
Signs and symptoms Diabetes Presence of insulin stored in the refrigerator. Bruising at insulin injection site on the abdomen. Abnormal blood glucose level. Normal blood glucose is 80-120 mg/dl. Hyperglycemia, >120 mg/dl, caused by a lack of insulin. High blood sugar level even after long time without food. Severe hyperglycemia Excess urination, with glucose in urine, leads to dehydration. Frequently thirst, urination and hunger. Fruity or acetone odor in breath. Hypoglycemia, <60 mg/dl, caused by over administration of insulin. Severe hypoglycemia triggers epinephrine release. Diaphoresis. Tremors. Weakness. Hunger. Tachycardia. Dizziness. Pale, cool and clammy skin. Warm sensation. Dehydration caused by excess glucose in the urine that causes large water loss through osmosis. Frequent thirst, urination, and hunger. Patient skipped a meal, medication, or had unusually vigorous activity. General altered mental status Anxiousness or combativeness. Trauma that indicates injury to the central nervous system. Mechanism of injury indicates trauma such as falls, even if it's from a medical condition. Unequal pupils that indicate head injury. Discoloration around the eyes. Discoloration behind the ears. Flexion or extension. Drug abuse. Pinpoint pupils. Dilated pupils. Suspect hazardous gas or poisoning if multiple patients have altered mental status. Inadequate breathing, which leads to hypoxia. Signs of hypoxia. Shock and hypoperfusion. Cool and clammy skin with pallor. Look for internal bleeding such as rigidity and tenderness in the abdomen. Look for external bleeding. Edema in the lower extremities or posterior sacral region which indicates congestive heart failure. Extreme tachycardia >160 that prevents the proper refilling of blood to the left ventricle. Inadequate perf Continue reading >>
Tom Lennon, Trainer, Emt, Endurance Athlete, Dad And Type 1 Diabetic
Tom Lennon, Trainer, EMT, Endurance Athlete, Dad and Type 1 Diabetic Posted By Tom Lennnon on Nov 10, 2017 12:35:00 PM I knew going into 2016 that it would be a year of big changes. My wife and I had just had our first son, we moved to Atlanta to be closer to family and I was starting a new career. Stressful as they are, I welcomed every one of those changes. Between stepping into the craziness of being a first-time dad and moving away from my whole life as a Bostonian, everything was in a constant state of motion. It was a roller coaster, but one that I loved riding. One change was not planned and it brought the whole ride to a stop. At 35, after a lifetime of perfect health, pushing myself as an endurance athlete, and barely seeing a doctor for any reason, I found out that I am a diabetic. Before leaving Boston I noticed that I had started losing weight. Ive been lifting for over 15 years and know my body and metabolism pretty well, but I still didnt think much of it. Once we were settled in Atlanta I found a new position at a local hospital. During my pre-employment screening more red flags popped up. When I left Boston I was 224 pounds. I weighed in at 201! I didnt think anything of it when they did a blood screen, figuring it was pretty routine. I also didnt give it a second thought when the nurse asked if I felt okay, what I ate for breakfast, or if my daily life had changed dramatically. After all the questioning, I wanted to know what my blood results were showing. The nurse told me my blood sugar was at 390 (keep in mind the average person is around 80 to 130). There was no way that my sugar was that high. The nurse instructed me to get one of those over the counter glucometers and do a 12 hour fast and check my levels. I can remember sitting in my car in the Continue reading >>
Emt Crews Often Unprepared For Diabetic Crises
EMT Crews Often Unprepared for Diabetic Crises FRIDAY, Jan. 26, 2018 (HealthDay News) -- If you call 911, you expect to get the medical services you need. But new research suggests that when it comes to severe low blood sugar episodes in people with diabetes , first responders might not be able to administer a potentially lifesaving medication called glucagon . Glucagon is an injectable medication that prompts the liver to release stored glucose. This quickly raises blood sugar. "In most states, basic EMTs [emergency medical technicians] cannot administer glucagon," said study senior author Dr. Robert Gabbay, chief medical officer at the Joslin Diabetes Center in Boston. But paramedics can give the injections, said Dr. Craig Manifold, medical director of the National Association of Emergency Medical Technicians. That's because paramedics get between 750 and 1,500 hours of education compared to about 100 to 150 hours of training for EMTs. Low blood sugar levels (hypoglycemia) generally occur in people with type 1 or type 2 diabetes taking insulin or other blood sugar-lowering medications. Researchers said more than 100,000 serious hypoglycemia episodes occur each year. Gabbay noted even U.S. Supreme Court justices aren't immune to this problem. Earlier this month, Justice Sonia Sotomayor, who has type 1 diabetes, had to call emergency services for help with serious low blood sugar. Early symptoms include shakiness, confusion and sweating. Left untreated, low blood sugar can cause seizures, unconsciousness and even death, according to the American Diabetes Association (ADA). These episodes can usually be treated with a food or drink containing fast-acting carbohydrates, such as glucose tablets, juice or sugar-sweetened soda, the ADA said. Sometimes the episodes are more Continue reading >>
Shared Flashcard Set
Details Title Chapter 17 Questions Description Emergency Care and Transportation of the Sick and Injured Total Cards 86 Subject Health Care Level Undergraduate 1 Created 03/12/2014 Click here to study/print these flashcards. Create your own flash cards! Sign up here. Additional Health Care Flashcards Cards Term Common signs and symptoms of diabetic coma include all of the following EXCEPT: A. warm, dry skin B. rapid, thready pulse C. cool, clammy skin D. acetone breath odor Definition C. cool, clammy skin Term Diabetes is MOST accurately defined as a/an: A. abnormally high blood glucose level B. disorder of carbohydrates metabolism C. lack of insulin production in the pancreas D. mass excretion of glucose by the kidneys Definition B. disorder of carbohydrates metabolism Term A 28-year old female patient is found to be responsive to verbal stimuli only. her roomate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she: A.has a urinary tract infection B. has low blood glucose level C. has overdosed on her insulin D. is signically hyperglycemic Definition D. is signically hyperglycemic Term The signs and symptoms of insulin shock are the result of: A. prolonged and severe dehydration B. fat metabolism within cells C. increased blood glucose levels D. decreased blood glucose levels Definition D. decreased blood glucose levels Term Kussmaul respirations are an indication that the body is: A. trying to generate energy by breathing deeply B. attempting to eliminate acids from the blood C. compensating for Continue reading >>
Emt - Chapter 17
Sort A 28-year-old female patient is found to be responsive to verbal stimuli only. Her roommate states that she was recently diagnosed with type 1 diabetes and has had difficulty controlling her blood sugar level. She further tells you that the patient has been urinating excessively and has progressively worsened over the last 24 to 36 hours. On the basis of this patient's clinical presentation, you should suspect that she: is significantly hyperglycemic. A 75-year-old male with type 1 diabetes presents with chest pain and a general feeling of weakness. He tells you that he took his insulin today and ate a regular meal approximately 2 hours ago. You should treat this patient as though he is experiencing: a heart attack. A 42-year-old male is found unresponsive on his couch by a neighbor. During your assessment, you find no signs of trauma and the patient's blood glucose level is 75 mg/dL. His blood pressure is 168/98 mm Hg, his heart rate is 45 beats/min and bounding, and his respirations are 8 breaths/min and irregular. The patient is wearing a medical alert bracelet that states he has hemophilia. You should: suspect that he has intracranial bleeding, assist his ventilations, and transport rapidly to an appropriate hospital. A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your primary assessment reveals that the patient is unresponsive and not breathing. You should check for a carotid pulse for no longer than 10 seconds. You are treating a 40-year-old male with a documented blood sugar reading of 300 mg/dL. The patient is semiconscious and breathing shallowly, and is receiving assisted ventilation from y Continue reading >>
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 >>
An Expert's Guide To Being Prepared Before Disaster Strikes
An Expert's Guide to Being Prepared Before Disaster Strikes Hurricanes, tornadoes, floods, and blizzards can destroy communities and take lives. Living with diabetes adds an extra layer of challenges. Here's what you need to know from an EMT who has type 1 diabetes. Record setting rainfall, lost lives, overflowing shelters, rivers instead of streets; Texas has been dealt a major blow from Tropical Storm Harvey . If you were faced with these grueling circumstances, would you be ready? Would you have all of your medications? The truth is, many of us would only have what is in our purses or daily kits, and that wont cut it for long. You may have to leave your home quickly, being unable to return for days or months, like the victims in Houston and other surrounding areas. If you or your loved one has type 1 or type 2 diabetes, its important to go above and beyond to be prepared in the event of a natural disaster. The need for a tightly monitored, life-dependent medication regimen and controlled nutrition means you need to be highly-organized and assertive when it comes to your emergency preparation. As a type 1 who is also an emergency medical technician (EMT), heres my guide to diabetes disaster prepthe ultimate insider, and outsiders, guide. The American College of Endocrinology has put together a Hurricane Katrina-inspired checklist for people with diabetes that includes items youll need to survive during a hurricane, flood, blizzard or any situation that may leave you stranded. Use a large plastic box, like youd use for Christmas decoration storage, to pack all of the supplies from the checklist. Personally, I think its wise to keep another mini kit available in your car. Of course, you cant store insulin there due to its sensitivity to harsh temperatures but I always Continue reading >>
The Ambulance Of Shame
I came out of my dreamlike state, trying to figure out where I was and what was happening. This didnt feel like my bed, or my couch. I could hear things but I didnt recognize the voices that were around me. He looks like hes coming out of it now, said one voice. Things started making a little more sense. It had happened again. I was in the back of an ambulance. I was coming out of an insulin shock. Can you hear me? shouted another. You had a little trouble. This isnt very good for you, you know. Suddenly I was awash in shame. I couldnt believe this happened to meagain. You really shouldnt let this happen to you, the second voice shouted. Then, just as quickly, shame changed to anger. I had been through this drill before. I had met an EMT team like this: Good EMT and Bad EMT, the one who did his/her job with compassion and skill, while the other castigated you. I wished I had said to the Bad EMT, How dare you! Who do you think you are, judging me? Instead, I was mute and in no condition for an argument. Ive lived 31 of my 44 years with Type 1 diabetes and, like everyone else whos dealing with this condition, sometimes my blood sugar levels drop. Usually Im able to handle it without anyone noticing. This time, though, it just got the better of me. During the ride, I slowly tried to retrace my steps to how I ended up this way. I had to drop a car off at my in-laws condo a little over a mile from my house. I could have taken a cab to get home, but it was just such a short walk and I thought Id get to enjoy the beautiful summer weather. Also, theres a Trader Joes just a couple blocks from the condo, so I figured Id do a little shopping on the way home. I was wearing my insulin pump and continuous glucose monitor on the walk. However, I had awakened several times the night b Continue reading >>
Learn: Emt Diabetic Emergencies Quiz Chapter 17 (by Kegusiso) - Memorize.com - Remember And Understand
versions of EMT Diabetic Emergencies Quiz chapter 17: main | yours | all (3) Metformin, a non-insulin medication, is another name for Diabetes is MOST accurately defined as a/an Patients with type II diabetes usually control their disease with all of the following, EXCEPT: supplemental insulin Insulin shock will MOST likely develop if a patient takes too much of his or her prescribed insulin Diabetic coma is a life-threatening condition that results in hyperglycemia, ketoacidosis, and dehydration fat metabolization when glucose is unavailable. Assessment of a patient with hypoglycemia will MOST likely reveal Excessive eating caused by cellular hunger is called Patients with uncontrolled diabetes experience polyuria because excess glucose in the blood is excreted by the kidneys Normal blood glucose levels, as measured by a glucometer, are is a condition in which no insulin is produced by the body The signs and symptoms of insulin shock are the result of Insulin shock tends to develop more often and more severely in children because they do not always eat correctly and on schedule Which of the following statements regarding diabetic coma is correct? a) Diabetic coma typically develops over a period of hours or days b) Diabetic coma can be prevented by taking smaller insulin doses c) Patients with low blood glucose levels are prone to diabetic coma d) Diabetic coma rapidly progresses once hyperglycemia develops a) Diabetic coma typically develops over a period of hours or days. Common signs and symptoms of diabetic coma include all of the following, EXCEPT: a) warm, dry skin b) rapid, thready pulse c) acetone breath odor d) cool, clammy skin Which of the following statements regarding glucose is correct? a) Blood glucose levels decrease in the absence of insulin b) The br Continue reading >>
Diabetic Emergencies: 5 Things Emts Need To Know
Diabetic emergencies: 5 things EMTs need to know What are the most important things to remember when treating a patient with a history of diabetes? In the United States, approximately 30 million people (or 9.4 percent of the population) have diabetes. However, 23.8 percent of those individuals have never received an official diagnosis. Furthermore, researchers estimate that 132,000 children under the age of 18 have diabetes[1]. Diabetes is a lifelong disease , which can be managed by a variety of treatment options. At its core, diabetes represents a dysfunction in the way the body processes sugar. The body either does not make enough of the hormone insulin, or it cannot effectively utilize insulin to move sugar from the bloodstream into the cells. Type 1 diabetes was once referred to as insulin-dependent diabetes or juvenile diabetes. However, type I diabetes can present at any age. Symptoms occur when the pancreas either makes an insufficient amount of insulin, or makes no insulin at all. Continue reading >>
Can You Be An Emt/paramedic With Diabetes?
By Elisabeth Almekinder RN, BA, CDE 8 Comments Note: This article has been updated after numerous comments. Recently, Jared contacted us with a question could he obtain a license to drive an ambulance in his home state of California, and work as an EMT/Paramedic while taking insulin? California is a bit tricky when it comes to who can obtain an Ambulance Drivers License, as are many other states. Becoming an EMT/Paramedic with diabetes, you may be required to drive the ambulance. Some states follow the federal guidelines for interstate trucking, where drivers must obtain a medical waiver for diabetes from the Federal Motor Carrier Safety Administration (FMCSA), when getting an ambulance drivers certificate as an EMT/Paramedic. Before we continue with this article, I wanted to let you know we have researched and compiled science-backed ways to stick to your diet and reverse your diabetes. Want to check out our insights? Download our free PDF Guide Power Foods to Eat here. For an EMT/Paramedic to get an ambulance drivers license with insulin-requiring diabetes, you must go through the process that exists in your home state. Each state and some jurisdictions have their own rules for driving and for levels and certification requirements for EMT personnel and Paramedics. It can take up to 90 days or more to get an ambulance drivers certification from your state Department of Motor Vehicles (DMV). You can appeal the decision if you get turned down the first time. The second time, you will have to provide your medical records to demonstrate that you are self-managing your diabetes. The rules and regulations are quite complicated, and a person with diabetes has a long process to go through when trying to get started in an EMS/Paramedic career. With perseverance, even a person Continue reading >>
Basic Emt Fall Session Chapter 17
Sort When obtaining a SAMPLE history from a patient with diabetes, it would be MOST important to determine: Choose one answer. A. if he or she has had any recent illnesses or excessive stress. Correct B. if there is a family history of diabetes or related conditions. Incorrect C. the name of the physician who prescribed his or her insulin. Incorrect D. approximately how much water the patient drank that day. Incorrect A. if he or she has had any recent illnesses or excessive stress. Diabetic coma is a life-threatening condition that results from: Choose one answer. A. hyperglycemia, excess insulin, and ketoacidosis. Incorrect B. hypoglycemia, excess insulin, and dehydration. Incorrect C. hypoglycemia, dehydration, and ketoacidosis. Incorrect D. hyperglycemia, ketoacidosis, and dehydration. Correct D. hyperglycemia, ketoacidosis, and dehydration. Diabetic ketoacidosis occurs when: Choose one answer. A. insulin is not available in the body. Correct B. the cells rapidly metabolize glucose. Incorrect C. the pancreas produces excess insulin. Incorrect D. blood glucose levels rapidly fall. Incorrect A. insulin is not available in the body. Assessment of a patient with hypoglycemia will MOST likely reveal: Choose one answer. A. warm, dry skin. Incorrect B. combativeness. Correct C. sunken eyes. Incorrect D. hyperactivity. Incorrect B. combativeness. A 29-year-old female presents with confusion and disorientation. Her respirations are rapid and shallow and her pulse is 120 beats/min and thready. She is markedly diaphoretic and has an oxygen saturation of 89%. You should: Choose one answer. A. provide ventilatory support. Correct B. administer oral glucose. Incorrect C. treat her for hyperglycemia. Incorrect D. transport immediately. Incorrect A. provide ventilatory support. A 4 Continue reading >>
Ems Treatment Of The Type 1 Diabetic Insulin Pump User
EMS Treatment of the Type 1 Diabetic Insulin Pump User By James Wenzel, EMT I ewqarudubxfzezxyvayatquuccaybd An EMS crew checks a patients insulin pump for information on why the patient is hypoglycemic. Photos and figures courtesy James Wenzel As an EMT, running calls for a Type 1 diabetic patient whos unresponsive is common. The reasons are endless: too much insulin, no food, too much exercise, stressed, feeling sick and so onresponding EMS providers usually dont have a sure answer as to why the patient is in their current condition. However, much like many aspects of EMS, technological advancements have helped. Insulin pumps are some of the most recent advancements in diabetic treatment. They not only aid the patient in tighter control of their diabetes, but can also aid first responders in their ability to treat the patient. Type 1 diabetes is an ever-growing medical condition. In 2012, 29.1 million people in the Unites States (9.3% of the population) had been diagnosed with diabetes. Of those, 1.25 million (5%) had Type 1 diabetes. Still, an estimated 8.1 million people had undiagnosed diabetes of some form. That year, diabetes patients cost the healthcare system $245 billion.1 With numbers like these, providers should become proactive in learning the newest methods in managing Type 1 diabetes. The world is working for a cure, on better treatments and better methods of control. As first responders, learning these new methods can help this population of patients and assist in removing diabetes as the seventh leading cause of death in the U.S.1 One step in achieving this is to understand the functions of insulin pumps. Insulin pumps came about in the 1970s and looked very different than they do nowthe first pumps were the size of backpacks. Just five years ago most Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Diabetes Apps Increase User Engagement But Should Be Doing Opposite
- Diabetes Apps Increase User Engagement But Should Be Doing Opposite
Diabetes Ceu Type 1 | Online Continuing Education
Nathalie Smith, MSN, RN ; Lisa M. Cockrell, PhD LEARNING OUTCOME AND OBJECTIVES: Upon completion of this course, you will be better prepared to appropriately care for patients with type 1 diabetes mellitus (T1DM) by identifying its health effects and evidence-based treatment guidelines, as well as the actions necessary to manage the disease. Specific learning objectives include: Differentiate type 1 diabetes from type 2 diabetes. Describe the epidemiology and pathogenesis of type 1 diabetes. Review the current criteria and strategies used to diagnose type 1 diabetes. Identify acute and chronic complications of type 1 diabetes and the associated interventions to avoid these complications. Discuss self-management of type 1 diabetes. Identify strategies to promote adherence to treatment regimens. Describe interdisciplinary collaboration as a management strategy. Type 1 diabetes mellitus (T1DM) is a serious endocrine condition that must be managed consistently by collaboration between the patient and healthcare providers to prevent serious short- and long-term complications. Careful treatment and patient adherence to lifestyle changes and appropriate therapies are necessary to prevent or minimize these complications. Commonly referred to as type 1 diabetes, T1DM is a pathologic condition in which the body is unable to properly store and process blood glucose. The monosaccharide (simple sugar) glucose is a critical carbohydrate used by cells as a source of energy. Normally, cells absorb circulating glucose from the blood in response to stimulation by insulin, a hormone produced by the islet cells of the pancreas. In patients with T1DM, a decrease in the concentration of circulating insulin impairs this function. As a result, blood glucose is not properly absorbed by cells a Continue reading >>
- Diabetes Type 2 CEU | Wild Iris Medical Education
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Remote type 2 education platform selected for NHS Innovation
Chapter 19 Quiz Flashcards Preview
A man finds his 59-year-old wife unconscious on the couch. He states that she takes medications for type 2 diabetes. He further tells you that his wife has been ill recently and has not eaten for the past 24 hours. Your assessment reveals that the patient is unresponsive. You should: A. open and maintain her airway and assess breathing. B. assess for the presence of a medical identification tag. C. administer 100% oxygen via a nonrebreathing mask. D. administer oral glucose between her cheek and gum. A. open and maintain her airway and assess breathing. A patient with an altered mental status; high blood glucose levels; and deep, rapid breathing may have a condition known as __________. A. Blood glucose levels decrease in the absence of insulin. B. The brain requires insulin to allow glucose to enter the cells. C. The brain requires glucose as much as it requires oxygen. D. Most cells will function normally without glucose. C. The brain requires glucose as much as it requires oxygen. Which of the following statements regarding sickle cell disease is correct? A. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. B. Because of their abnormal shape, red blood cells in patients with sickle cell disease are less apt to lodge in a blood vessel. C. Sickle cell disease is an inherited blood disorder that causes the blood to clot too quickly. D. The red blood cells of patients with sickle cell disease are round and contain hemoglobin. A. In sickle cell disease, the red blood cells are abnormally shaped and are less able to carry oxygen. Continue reading >>
