[laughing] Speaker 2: Elizabeth, are you feeling okay? Speaker 3: I don't know. I don't feel
very good. Speaker 2: I think we should go find some help. Speaker 1: Now let's take
a closer look at diabetic emergencies. When we talk about diabetic emergencies, we could
get really, really intricate about what causes it and is it insulin resistance and all that
kind of stuff, but I think for the sake of this training, we're going to simplify it
down to two major types of emergencies that can occur due to a diabetic emergency and
that is this: high blood sugar and low blood sugar. Now, let's break those out a little
bit. High blood sugar and low blood sugar, though they have the similar signs and symptoms,
high blood sugar is different for a couple different reasons. High blood sugar can develop
in hours to days, and when it develops, it's a little bit different in that it also shows
some symptoms like a child needing to drink more often than normal. Maybe they're drinking
more water, maybe they're drinking more pop, maybe they're just always thirsty. We call
this polydipsia. Polydipsia is that insatiable thirst that they cannot quench. Now, when
they have this symptom, it's usually accompanied with having to go to the bathroom a lot as
well. That's another way that the body's trying to get rid of that excess sugar in their bloodstream
and in their tissues and that's by going to the bathroom a lot. So another sign or symptom.
Now, backing up just a little bit, let's say that you didn't know that the child was a
diabetic. These are sometimes the first signs of juvenile diabetes is that we see the child
drinking more than they usually do and going to the bathroom more than they usually do.
Not that that's always for sure, but it's definitely a flag that should maybe bring
us to the doctor and take a closer look. And now back on track with the high blood pressure.
One of the last symptoms that's really bad and is usually at the tail end of a high blood
sugar event is something we call ketoacidosis. Now ketones can be actually smelled on the
breath of a high blood sugar patient. It's usually like cheap wine or a fruity overtone,
and that can be an indicator that the person is suffering from high blood sugar. So what
can we really do about high blood sugar out in the field? Not a whole lot. We can activate
emergency medical services or get the person to an emergency room so that they can be definitively
treated and get back on track. Now let's focus more on the one that you can do something
about in the field, and that's low blood sugar. So, in a low blood sugar event, it's different
from high blood sugar in that it can come on within seconds to minutes and it can surprise
people. Whether they're a known diabetic or an unknown diabetic, the treatment should
be about the same. So what is the goal of getting someone into a more stable position
when they have a low blood sugar event and are showing those signs and symptoms of dizziness,
lethargy, they might be confused, they might have slurred speech, they don't want to play
anymore, they're grumpy? Getting them sugar. But there's different ways to get the sugar
into their system faster than others, and I want to talk about that here in just a minute.
There's lots of different food sources around that we can choose from but not all of them
will get the sugar into the bloodstream as quickly as the ones I'm going to talk about
next. If you look at some of these high-grain, high-fiber snacks that are common at a picnic
table, they're good and in some cases they're good for you, but they're not necessarily
good to treat a diabetic emergency. Meat sticks, granola bars, and chips are probably not our
first choice to getting their blood sugar up. Though they can over a longer period of
time, that's not our emergency treatment. I want to take a look at some that are a little
bit faster and are more preferable under the treatment guidelines. Orange juice is a fantastic
way to get their sugar up. In this one small bottle, there's literally 44 grams of sugar.
They shouldn't have to drink much more than a third to a half the full container to give
them more than enough sugar to get their blood sugar level back to where it should be, get
them thinking more clearly, and then buy us some time for EMS to arrive or to get them
to their doctor or to an emergency room. A couple other options that you could use are
over-the-counter, you could get them at most drug stores, probably some grocery stores,
and that's glucose in the form of tablets, in the form of liquid, and in the form of
a gel. The reason I like these is that they're closed, sealed bottles, and they're really
stored in a more stable state. You got orange juice here, but in most cases it needs to
stay refrigerated, and it has an expiration date that probably is a little faster than
some of these other options. Now, I like these because, depending on the child, they may
have something that they like more than the other. Maybe they like chewing candy so you
would opt for the tabs, but keep in mind that you should know, and here's a little Roy hint,
you might want to write on this the number that you should be using, your doctor would
probably tell you this, because in this case, every tablet's only 4 grams of sugar. So you
might think it's one tablet per treatment, but in actuality, to equal the half of this
bottle, you need five tablets. It's four grams per tablet, you would like five to equal the
half bottle of orange juice. The liquid here comes in 22 grams by itself, and the gel is
another 18 grams. So understanding how much sugar or glucose is actually in these tabs
is important. Remember that these have been designed to absorb quickly into the digestive
tract of the patient, and so they may work a little faster than a candy or a regular
soda. Now, one point of interest here where we come to drinking over-the-counter beverages
is be careful of diet things. Diet sodas tend not to have any sweetener that's sugar-based
or glucose-based at all. So we've actually, I've had patients who they've gotten treated
with diet pop and their family didn't understand why it didn't bring their loved one around.
Well, it was because there wasn't any sugar in the soda. So make note of that, no diet
sodas, no diet candies, they won't work in this situation. The second point is that it
can take up to fifteen minutes to actually absorb the amount of sugar or glucose needed
to reverse the effects of a hypoglycemic event. So remember, if this person is a known diabetic
and a doctor is giving you a prescription of what to do if they have a low blood sugar
event, it may be that after you give them the appropriate amount of sugar or glucose,
that you wait five, ten, fifteen minutes to see if it reverses the hypoglycemic symptoms
before you activate emergency medical services. However, if this is your first hypoglycemic
event, it's going to be important to call 9-1-1 right away. The other piece here to
note, in closing, is that when we have these different packages, they almost all come with
a seal. As I was preparing these for this instructional, I was picking at the actual
seal, and I realized that some of them are very difficult to undo. Now, keep in mind,
some of the effects of the decreased level of consciousness and confusion is only going
to make opening these that much more difficult. So if you can take the outer seal off, it's
just a protective device so that you know it has never been opened, get it prepared
so that you can open it more easily and consume its contents when it's an emergency and it
counts. So, I hope this helps, wait for EMS, watch the patient to develop any life-threatening
problems, and if they do, we'll know what to do, we can move on to our next level of
treatment.