Emergency Medical Services Program

1. Emergency Medical Services Program Diabetic emergencies

2. Diabetic emergencies LEARNING OBJECTIVES • Understand Diabetes Mellitus and risk factors and symptoms of • Understand Hyperglycemia and Hypoglycemia and signs and symptoms of • Learn how to use a glucometer • Learn how to assist with the administration of oral glucose

3. Diabetic emergencies Unit One Diabetes Mellitus

4. Diabetic emergencies Diabetes Mellitus A condition brought about by decreased insulin production, or the inability of the body cells to use insulin properly that prevents the body’s cells from taking the simple sugar called glucose from the bloodstream.

5. Diabetic emergencies Diabetes Mellitus Glucose Homeostasis

6. Diabetic emergencies Diabetes Mellitus – Risk Factors Some risk factors include: • Obesity • Sedentary Lifestyle • Family History • Hypertension • Low High Density Lipids (HDL) • Elevated Triglycerides

7. Diabetic emergencies Diabetes Mellitus – Signs and Symptoms Some signs and symptoms include: • Frequent Urination • Excessive Thirst • Weight Loss • Hunger • Fatigue • Slow Healing Wounds

8. Diabetic emergencies Unit Two Hyper and Hypo Glycemia

9. Diabetic emergencies Hyperglycemia (High Blood Sugar) Is a condition that refers to an abnormally high level of sugar, or glucose in the blood. Normal Blood Sugar (Fasting-no food for eight hours): 70 – 99 mg/dL Normal Blood Sugar (Two hours after eating): 140 mg/dL

10. Diabetic emergencies Hyperglycemia (High Blood Sugar)

11. Diabetic emergencies Hyperglycemia (High Blood Sugar) Main symptoms are: • Increased Thirst • Frequent Urination Diabetic Ketoacidosis is a severe elevation in blood glucose. This is a life threatening medical emergency. Symptoms include: • Vomiting • Confusion • Fruity Odor to the breath • Shortness of Breath

12. Diabetic emergencies Hypoglycemia (Low Blood Sugar) Is a condition that refers to an abnormally low level of sugar, or glucose in the blood. Normal Blood Sugar (Fasting-no food for eight hours): 70 – 99 mg/dL Normal Blood Sugar (Two hours after eating): 140 mg/dL

13. Diabetic emergencies Hypoglycemia (Low Blood Sugar)

14. Diabetic emergencies Hypoglycemia (Low Blood Sugar) Main symptoms are: • Fatigue • Heart Palpitations • Sweating • Tingling sensation around mouth Severe Hypoglycemia can be a life threatening medical emergency. Symptoms include: • Seizures • Confusion/Abnormal behavior • Slurring of speech/Appearance of intoxication

15. Diabetic emergencies Unit Three Glucometers and Glucose

16. Diabetic emergencies Glucometers A glucometer is a medical device for determining the approximate concentration of glucose in the blood. It measures in milligrams per deciliter (mg/dL).

17. Diabetic emergencies Treatment of Diabetes (Hypoglycemia) Using the Glucometer Materials needed: • Blood glucose meter • Vial of test strips • Lancing device • Lancets • PPE’s (medical gloves, eye protection)

18. Diabetic emergencies Treatment of Diabetes (Hypoglycemia) Using the Glucometer – Step One • Place the end with the 3 contact bars into the meter. • The meter will turn on automatically and display a number code. • Check the code to make sure it matches the number code on the vial of test strips. • If the number code on your meter doesn’t match the number code on your test strip vial, you won’t get an accurate reading. • If the numbers don’t match, follow the instructions that came with your meter to change the meter. code.

19. Diabetic emergencies Treatment of Diabetes (Hypoglycemia) • Using the Glucometer – Step 2 • Get a blood sample • Use a lancing device and a new lancet to get a drop of blood from the fingertip. Getting the blood from the side of the fingertip makes it easier to apply the blood to the test strip.

20. Diabetic emergencies Treatment of Diabetes (Hypoglycemia) • Using the Glucometer – Step 3 • Apply blood to strip • When the blood droplet symbol appears in meter window, apply blood to strip • Make sure that the channel in the strip is completely full. This ensures that your meter has a large enough blood sample to give you an accurate reading. • **If your sample doesn’t fill the channel, add more blood to that strip within 5 seconds. If you get an error reading, discard the strip and start again**

21. Diabetic emergencies Treatment of Diabetes (Hypoglycemia) • Using the Glucometer – Step 4 • Read the result • Your meter will count down and display the result of your blood glucose level.

22. Diabetic emergencies Treatment of Diabetes (Hypoglycemia) Diabetes can be treated with injections ofinsulin or oral glucose medications. CAL FIRE (PSFA) providers will only assist in administering oral glucose medications.

23. Diabetic emergencies Treatment of Diabetes (Hypoglycemia) • Public Safety First Aid trained personnel can assist with glucometer use and administration of oral glucose in a hypoglycemic patient. • Certified Emergency Medical Technicians can use a glucometer to get a glucose reading and to administer oral glucose or monitor intravenously (IV) lines delivering glucose solutions.

24. Diabetic emergencies Treatment of Diabetes (Hypoglycemia) Patient Assessment • Look for indicators in the patient: • Presents with signs and symptoms of Hyperglycemia • Medical Identification (Bracelet, etc.) • A history of diabetes • Altered mental status • Can patient swallow and protect their airway

25. Diabetic emergencies Treatment of Diabetes (Hypoglycemia) Oral Glucose Administration • If patient is alert: • Patient will self-administer glucose • If patient cannot self-administer: • PSFA providers can assist patient in administering oral glucose as needed for patient to receive medication

26. Diabetic emergencies ADDITIONAL RESOURCES: American Diabetes Association: http://www.diabetes.org

27. Diabetic emergencies Questions?