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Skills Training Session February 11 , 2014. Agenda. Quiz Run report guidelines, feedback Scenario Debrief Diabetic Emergencies. Run Reports. Return reports from last week Run report cards Neatness, clarity, completeness Questions?. Scenario.
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Skills Training Session February 11, 2014
Agenda • Quiz • Run report guidelines, feedback • Scenario • Debrief • Diabetic Emergencies
Run Reports • Return reports from last week • Run report cards • Neatness, clarity, completeness • Questions?
Scenario • 23 y.o. M/F @ [Location] c/c dizziness.
Diabetic Emergencies • Diabetes mellitus • Type 1: insulin-dependent • Hereditary • Need for daily insulin injections • Type 2: non insulin-dependent • Patient produces inadequate amounts of insulin or is resistant • Controlled by diet or oral hypoglycemic drugs • Normal range for blood glucose is 80-120 mg/dL
Diabetic Emergencies • Hypoglycemia: • Blood glucose level <80 mg/dL • Can lead to insulin shock • Pale, moist skin • Dizziness, altered LOC • Hunger • Seizure, coma, death
Diabetic Emergencies • Hyperglycemia: Blood glucose 120-400 mg/dL • Diabetic keto-acidosis (DKA) 400-800 mg/dL • Diabetic coma possible above 800 mg/dL • Symptoms: • Kussmaul respirations: deep, labored breathing • Rapid, weak pulse • Fruity breath • Altered LOC/unresponsiveness • Dry, warm skin
Diabetic Emergencies • DKA and insulin shock appear very similarly, how do we tell the difference? • SKIN SIGNS! “hot and dry, my sugar is high. Pale and clammy, need some candy” • Appears similar to EtOH
Diabetic Emergencies • Treatment: • Oral glucose, given to a patient with a decreased level of consciousness with a Hx of diabetes • One dose is one tube • Squeeze onto tongue depressor or swab and spread inside Pt’s cheek. • Never stick your finger’s in a patients’ mouth • Pt must have a gag reflex and be conscious • Low LOC, Pt may lose gag reflex • O2 via NRB, 15 L/min
Diabetic Emergencies • Treatment: • If Pt is unconscious, do not try to give glucose. • Maintain airway and transport, Pt needs IV glucose.