TL;DR
Diabetic Emergencies: Hypoglycemia (<60 mg/dL) and hyperglycemia/DKA (>300 mg/dL with acidosis).
Diabetic Emergencies
Definition
Hypoglycemia (<60 mg/dL) and hyperglycemia/DKA (>300 mg/dL with acidosis).
Assessment Techniques
Assessment techniques for diabetic emergencies:
- SAMPLE
- Components: Signs/symptoms, Allergies, Medications, Past history, Last intake, Events. Scoring: Mnemonic for patient history gathering
- Trauma Score
- Components: GCS, Systolic BP, Respiratory rate. Scoring: Revised Trauma Score: coded values 0-4, sum correlates with survival probability
- APGAR
- Components: Appearance, Pulse, Grimace, Activity, Respiration. Scoring: 0-10 at 1 and 5 minutes, under 7 needs intervention
Common Errors
Critical errors in prehospital application of diabetic emergencies:
- Failing to reassess after intervention. Vital signs must be rechecked every 5 minutes for unstable patients
- Incorrect medication dosing. Always use length-based estimation (Broselow tape) for pediatric patients
- Tunnel vision on one finding while missing the complete clinical picture
- Not communicating changes to receiving facility during transport
Practical Example
Field Scenario: An elderly woman found on the floor after a fall. Alert but confused, hip pain with external rotation and shortening of right leg. Suspect hip fracture: splint in position found, monitor for shock.
This scenario tests your ability to apply knowledge of diabetic emergencies under time pressure with incomplete information, exactly the type of decision-making the certification exam assesses.
Equipment & Tools
Equipment used in diabetic emergencies assessment and treatment:
- King airway
- Supraglottic blind-insertion airway device. Available sizes: Size 3 (4-5 ft), Size 4 (5-6 ft), Size 5 (over 6 ft)
- AED
- Automated external defibrillator for VF/pVT. Available sizes: Adult pads (over 8yo or 25kg), Pediatric pads (under 8yo or 25kg)
- Pulse oximeter
- Measures SpO2 via infrared absorption through capillary bed. Available sizes: Finger clip, Earlobe, Pediatric wrap
Documentation
Documentation of diabetic emergencies in the patient care report (PCR) must include: time of assessment, findings, interventions performed, patient response, and reassessment findings. Use objective, measurable terms like "patient reports 8/10 chest pain" rather than "patient in pain." Document pertinent negatives. All medications administered must include drug name, dose, route, time, and patient response.
Why It Matters
Differentiating and treating these conditions is tested on EMT and Paramedic exams.
Related Terms
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