1. DIABETES/E TOH STS 4/6/2015

2. DIABETES Type 1: insulin-dependent Hereditary Need daily insulin injections Type 2: non insulin-dependent Doesn’t produce enough insulin or resistant Controlled by diet or oral hypoglycemic drugs What is the normal range for blood glucose? 80-120 mg/dL

3. HYPOGLYCEMIA What are signs/symptoms? Glucose level < 80 mg/dL Insulin shock Pale, moist skin (“cool & clammy, need some candy”) Dizziness ALOC Hunger Seizure, coma

4. HYPERGLYCEMIA What’s the difference in blood glucose levels between DKA and diabetic coma? DKA: 400-800 mg/dL Diabetic coma: > 800 mg/dL Signs/symptoms: Kussmaul respirations: deep, labored breathing Rapid/weak pulse Fruity breath Altered LOC/unresponsiveness Dry, warm skin

5. DIABETIC EMERGENCY TREATMENT Oral glucose, one tube onto a tongue depressor and spread on the inside of the pt’s cheek Indications: Decreased level of consciousness History of diabetes Gag reflex Must be conscious Give O 2 via NRB, 15 L/min if signs of respiratory distress Transport!!

6. ETOH May present similarly to diabetic emergencies, among other conditions Trauma Shock Electrolyte disturbances Cardiac disorders

7. ETOH Verbal assessment: Pay attention to your SAMPLE Consider weight of the patient when taking into consideration substance abuse Additional questions you may want to ask: What additional substances has pt. been taking? How long ago was this taken? How much did the pt. consume?

8. ETOH Reminders: Do your assessment! EtOH patients may not be the most cooperative, so be friendly, but firm. If pt. is unresponsive, gather as much information from bystanders as possible. Be prepared to suction! Have oxygen on deck. Consider additional factors.

9. SCENARIO Your dispatch call: