skills training session february 11, 2014. agenda quiz run report guidelines, feedback scenario...
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Skills Training SessionFebruary 11, 2014
Agenda
• Quiz• Run report guidelines, feedback• Scenario• Debrief• Diabetic Emergencies
Run Reports
• Return reports from last week• Run report cards• Neatness, clarity, completeness• Questions?
Scenario
• 23 y.o. M/F @ [Location] c/c dizziness.
Diabetic Emergencies
• Diabetes mellitus– Type 1: insulin-dependent• Hereditary• Need for daily insulin injections
– Type 2: non insulin-dependent• Patient produces inadequate amounts of insulin or is
resistant• Controlled by diet or oral hypoglycemic drugs
• Normal range for blood glucose is 80-120 mg/dL
Diabetic Emergencies
• Hypoglycemia:– Blood glucose level <80 mg/dL– Can lead to insulin shock• Pale, moist skin• Dizziness, altered LOC• Hunger• Seizure, coma, death
Diabetic Emergencies
• Hyperglycemia: Blood glucose 120-400 mg/dL• Diabetic keto-acidosis (DKA) 400-800 mg/dL• Diabetic coma possible above 800 mg/dL
– Symptoms: • Kussmaul respirations: deep, labored breathing• Rapid, weak pulse• Fruity breath• Altered LOC/unresponsiveness• Dry, warm skin
Diabetic Emergencies
• DKA and insulin shock appear very similarly, how do we tell the difference?• SKIN SIGNS! “hot and dry, my sugar is high. Pale and
clammy, need some candy”
• Appears similar to EtOH
Diabetic Emergencies
• Treatment:– Oral glucose, given to a patient with a decreased
level of consciousness with a Hx of diabetes• One dose is one tube• Squeeze onto tongue depressor or swab and spread
inside Pt’s cheek. • Never stick your finger’s in a patients’ mouth• Pt must have a gag reflex and be conscious
– Low LOC, Pt may lose gag reflex
– O2 via NRB, 15 L/min
Diabetic Emergencies
• Treatment:– If Pt is unconscious, do not try to give glucose. – Maintain airway and transport, Pt needs IV
glucose.
THANK YOU
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