This document provides information on diabetic emergencies, altered mental status, seizures, strokes, dizziness, and syncope. It discusses signs and symptoms, patient assessment, and emergency care steps. Key points include administering oral glucose for hypoglycemic patients who can swallow, positioning seizure patients on their side and protecting airway after, and using the Cincinnati Prehospital Stroke Scale to assess for facial droop, arm drift, and slurred speech to identify potential stroke patients.

1. Chapter Diabetic Emergencies and Altered Mental Status Fifteen

3. Altered Mental Status K EY TERM Any mental status that is not normal or expected for that patient

6. D IABETIC EMERGENCIES

7. Diabetes K EY TERM Condition brought about by decreased insulin production, which prevents the body’s cells from taking the simple sugar called glucose from the bloodstream

8. Insulin allows sugar to pass from the bloodstream into the cells.

9. Diabetes is treated with injections of insulin or oral medications.

10. Diabetic patients test their blood glucose at home.

11. Blood Glucose Meters

12. Prepare blood glucose meter and test strip.

13. Cleanse skin with alcohol prep.

14. Use lancet to perform finger stick.

15. Apply the blood to test strip.

16. Read blood glucose test results.

17. Blood Glucose Readings 80-120 mg/dl Normal 60-80 mg/dl Moderate hypoglycemia Below 50 mg/dl Severe hypoglycemia Above 140 mg/dl Hyperglycemia Question results that are inconsistent with patient’s condition.

19. Hypoglycemia Hypoglycemia (low blood sugar) is a life-threatening emergency for people with diabetes. But it is one that the EMT-B can treat. K EY TERM

33. A DMINISTRATION OF ORAL GLUCOSE

34. Squeeze glucose onto tongue depressor and place between cheek and gums. If patient is awake enough, let her squeeze oral glucose into mouth.

35. When glucose is gone, remove tongue depressor and reassess patient.

36. If patient loses consciousness, remove tongue depressor, secure airway, and transport promptly.

43. Seizure Sudden change in sensation, behavior, or movement caused by irregular electrical activity of the brain K EY TERM

49. Status Epilepticus A life-threatening condition in which the patient has two or more convulsive seizures without regaining consciousness K EY TERM

51. S TROKE

54. Cincinnati Prehospital Stroke Scale Assess for 1) facial droop, 2) arm drift, and 3) slurred speech

55. If the patient’s family members say he/she is just “acting a little strange” or “not him/herself ” the EMT-Basic should always consider the possibility of a diabetic emergency or stroke. Sometimes early symptoms of these medical problems are subtle and overlap. Becoming experienced at obtaining a history and understanding the medications that patients take can help you uncover clues to the problem the patient may be experiencing today. P RECEPTOR P EARL

60. Cincinnati Prehospital Stroke Scale Have patient attempt to smile.

61. Cincinnati Prehospital Stroke Scale Have patient attempt to hold arms straight in front of them for 10 seconds.

62. Cincinnati Prehospital Stroke Scale Evaluate patient’s speech.

71. 1. List the signs and symptoms of hypoglycemia. 2. What are five causes of seizures? 3. Explain how to do the Cincinnati stroke scale. R EVIEW QUESTIONS