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EMT > Diabetes Medical Emergency > Flashcards

Diabetes Medical Emergency Flashcards

1
Q

Diabetes Mellitus

A

-Changes pt’s mental status/LOC from alterations in the blood glucose(Blood sugar) levels

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2
Q

Diabetes can lead to complications like_________

A
  • Vascular disease
  • Stroke
  • MI
  • Nerve dysfunction
  • Kidney Failure
  • Blindness
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3
Q

Glucose starts as?

A

Carbohydrates(complex sugars) broken down into simple sugars

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4
Q

How many percent % of simple sugar is glucose?

A

80%

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5
Q

Three types of simple sugars

A
  • Glucose
  • Galactose
  • Fructose
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6
Q

Glucose

A
  • The major source of fuel for the cells

- The brain can only use glucose, without it cells will shut off and die

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7
Q

Other cells (not including brain cells) can use what other source of energy other than glucose?

A

-Fats and proteins but they produce harmful by-products that eventually affect the cell function adversely.

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8
Q

Insulin

A

-A hormone secreted from the pancreas when BS level rise and help carry glucose in the cells
-Promotes movement of Glucose out of the blood and into the cells
-causes liver to take Glucose and convert it into glycogen (stored form of glucose)
-Decreases blood glucose level by those
actions

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9
Q

What is the “key” to unlock the cel and get glucose into the cell?

A

Insulin

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10
Q

Without insulin

A
  • Glucose get into cells at a rate 10x slower

- The brain does not need insulin to uptake glucose

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11
Q

Glucagon

A

-Secreted from the pancreas when BS levels are low

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12
Q

Functions of Glucagon

A
  • Converts glycogen stores in the liver back into glucose and release it into the blood
  • Converts other, noncarbs substances into glucose in the liver
  • Increases and maintains the BS levels by converting glycogen & other substances into glucose
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13
Q

Normal metabolism

A
  • Eat a meal
  • BS levels rises 120-140 mg/dL
  • insulin secreted
  • Cells receive glucose, liver creates glycogen
  • BS levels drop less than or equal to 70 mg/dL
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14
Q

What happens to a Normal metabolism when you haven’t had a meal yet?

A
  • Glucagon secreted
  • Glycogen produces glucose, non-carbs produce glucose
  • BS Increased/maintained
  • then you eat
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15
Q

How to check BS levels

A
  • Done with a glucometer

- Finger stick/IV catheter

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16
Q

BS levels for hypoglycemia

A
  • BS less than or equal to 60mg/dL with Sx

- BS less than 50mg/dL without Sx

17
Q

Hyperglycemia BS level

A

-BS greater than 120mg/dL

18
Q

The 3 P’s

A
  • Polydipsia-frequent thirst
  • Polyuria-frequent ruination
  • Polyphagia-frequent hunger
19
Q

DM type 1

A
  • AKA juvenile onset
  • Insulin dependent diabetes mellitus (IDDM)
  • Mostly children with DM are IDDM
20
Q

DM type 2

A
  • AKA adult onset
  • Non-Insulin dependent Diabetes Mellitus (NIDDM)
  • Pancreas produces a reduced amount of insulin
21
Q

Hypoglycemia

A
  • know as insulin shock
  • Low BS
  • more common in type 1 IDDM
  • Most common cause of coma in DM Pt
  • Sx brain cell dysfunction
  • Pt takes insulin and does not eat
  • Pt takes insulin, eats, but increases activity level
  • Pt takes too much insulin
22
Q

Hypoglycemia can also cause what to be released?

A
  • Decreases BS level causes epinephrine to be released, to stop insulin release and stimulate glucagon release
  • Hypoglycemic Pts will have Sx of epi release
23
Q

Sx of Epi release

A
  • Tremors/weakness
  • Hunger/Tachycardia
  • Dizziness
  • Pale,cool,clammy skin
  • sweating
  • warm sensation
24
Q

Sx of brain cell dysfunction

A
  • Confusion ALOC
  • Drowsiness
  • Disorientation/Combative
  • Unresponsive
  • Seizure
  • Stroke like Sx
25
Q

Rx for Hypoglycemia

A
  • ABCs
  • Contact ALS if Pt is unresponsive
  • Obtain BS if possible
  • Oral Glucose
26
Q

Oral glucose

A

-Increases the amount of sugar circulating in the blood

27
Q

You can give Oral glucose if Pt meets these criteria

A
  • If hypoglycemia is suspected or Pt’s glucometer reads BS less than or equal to 60mg/dL
  • Pt is awake and able to swallow give 15g
28
Q

Hyperglycemia

A
  • High BS levels
  • Diabetic Ketoacidosis (DKA) more common in type 1 DM
  • Hyperglycemic hypersmolar nonketotic syndrome (HHNS) more common in type 2 DM
29
Q

Diabetic Ketoacidosis (DKA)

A
  • BS >350mg/dL
  • Brain is ok but other cells are suffering
  • Cells burn fat for energy
  • Glucose collects in the blood
  • Occurs over days
30
Q

Excess glucose can lead to?

A
  • Dehydration

- Acidosis

31
Q

Why do hyperglycemic pt become dehydrated ?

A
  • Since there’s little to no insulin cells starve which then the brain calls for glucagon, which then more glucose are produced.
  • since there’s already excess amount of glucose in the blood, it spills into the urine, and since water is attracted to glucose the urine takes large amount of water with it when urinating
32
Q

Acidosis

A
  • Liver cells start burning fat for fuel
  • Produces a byproduct “ketones”
  • ketones produce a form of strong acid
  • Increase acid levels are dangerous to the body
  • Electrolyte imbalances will lead to cardiac dysrhythmias
  • Brain function can be disturbed
33
Q

Causes of DKA

A
  • Infection upsetting insulin glucose balance
  • Inadequate dose of insulin
  • Certain meds
  • Stressful event: surgery, trauma, MI
  • Change in diet: Overeaten carbs/sugars
34
Q

Sx of DKA

A
  • Tachycardia/ poor skin turgor(Dehydrated skin)
  • Rapid respiration/kussmaul
  • Fruity acetone door to breath
  • positive orthostatic test, N/V
  • Muscle cramps/ALOC
  • Coma-very late Sx
  • 3 p’s
35
Q

Rx for DKA

A
  • ABCs
  • Call ALS if unresponsive
  • Check BS if possible
  • If BS is unobtainable and pt is layered & known DM, give oral glucose
36
Q

Hyperglycemic Hyperosmolar nonketotic syndrome (HHNS)

A
  • More common in type 2 NIDDM
  • BS levels 600-1200mg/dL
  • Extreme dehydration because of large amounts of Sugar not acidosis
  • type 2 Pt’s liver does not burn fat as much as Type 1 Pt because more insulin is still produced in the pancreas
37
Q

Sx (HHNS) Hyperglycemic Hyperosmolar Nonketotic Syndrome

A
  • Tachycardia/Fever
  • positive orthostatic/Dehydration/thirst
  • Poor skins warm dry
  • ALOC
  • N/V
38
Q

Rx (HHNS) Hyperglycemic Hyperosmolar Nonketotic Syndrome

A
  • ABCs
  • Call ALS if unresponsive
  • Check BS if possible
  • If BS is unobtainable and pt is layered & known DM, give oral glucose
39
Q

AEIOUTIPS

A
  • Alcohol
  • Epilepsy
  • Insulin
  • Overdose/Underdose
  • Uremia
  • Trauma
  • Infection
  • Physic
  • Shock

EMT (26 decks)

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