Diabetic Emergencies

You are reviewing prehospital care reports and notice that a patient with low blood sugar and no contraindications to oral glucose did not receive the medication. You recognize that this inaction placed the patient at risk for what condition?

• infection

• heart failure

• liver damage

• brain damage

You determine a patient's blood glucose level to be 289 mg/dl. You document this result on the prehospital care report as:

• depressed

• normal

• hyperglycemic

• hypoglycemic

After you administer oral glucose to a confused and combative patient, she gradually becomes calmer and fully oriented. As a knowledgeable EMT, you would recognize that the patient:

• had a high blood-sugar level

• will need a second dose of oral glucose

• had a low blood-sugar level

• now has a decreasing blood sugar level

You are instructing EMT students on how to obtain a blood sample to use in a glucometer. You are providing accurate information by stating which one of the following?

• "A small drop of blood obtained from the patient's fingertip is sufficient."

• "It is best to check the blood three times and then use the highest reading."

• "Approximately 15 ml of blood will be needed for an accurate result."

• "Have the patient raise his or her arm in the air prior to obtaining blood."

What is the best action to take prior to administering oral glucose?

• Ask if the patient is allergic to glucose.

• Determine the patient's blood glucose level.

• Determine if the patient is pregnant.

• Make sure the patient has insulin available if needed.

You are transporting a diabetic who has low blood sugar. En route you have received orders to administer oral glucose. What piece of emergency equipment is it most important to have readily available during this procedure?

• Nasopharyngeal airway

• Automated external defibrillator

• Oropharyngeal airway

• Suction device

A 17-year-old patient is unresponsive. A medical identification bracelet states that he is diabetic. Which of the following actions should be your first in the care of this patient?

• Assess the airway.

• Check for a pulse.

• Determine the type of diabetes.

• Administer oral glucose.

You have been called for an adult male who is hypoglycemic and responsive to painful stimuli. The family has oral glucose and wants you to administer it. However, at this time, your medical director has not authorized its use and there are no protocols regarding its use. Given the patient's condition and the family's request, which one of the following actions should you take?

• Carefully administer the oral glucose at the family's request.

• Contact medical direction for permission to administer the glucose.

• Instruct the family to administer the oral glucose.

• Transport the patient to the emergency department.

You have been called to a residence for a patient with altered mental status. On arrival a neighbor informs you that he saw the patient washing windows several minutes earlier and then suddenly saw him lying on the ground. He continues by stating that the patient is diabetic and has been in and out of the hospital lately because his blood sugar has been dropping suddenly. Your scene size-up reveals the patient to be lying next to a ladder propped up to the second-story window. Water from a bucket is spilled on the side of the house and yard. The patient is supine and unresponsive. Which one of the following should be your next most immediate action?

• Take manual in-line spinal stabilization.

• Insert a nasopharyngeal airway.

• Open the airway with the jaw-thrust maneuver.

• Check the glucose level and administer oral glucose if needed.

The EMT should suspect that a patient is diabetic when which one of the following medications is found on the scene?

• Ecotrin

• Lexapro

• Byetta

• Nitrostat