Diabetic in the public

Nurses General Nursing

Published

Again, at the CPR class...Okay...here's another scenerio, something I disagreed with again. Shame one me....Remind me to never take a medical class from anyone else other than a medically trained professional. Ok here goes....what would you do...??

You are in the grocery store and a 28 year old female collapses to the floor. She responds to you when you talk to her, but she is not lucid and she stares off. She is lethargic and is acting drunk. She tells you that she is a diabetic. She doesn't tell you anything else.

Do you rush to the candy isle seeking SUGAR? Or do you ask her if she took her insulin today? Is there a possibility that she may be HYPERglycemic versus HYPOgyclemic? Maybe she didn't take her insulin and she ate something thinking she would be home in enough time to get her insulin....but the store was busier than she thought and she was held up longer....

Am I wrong? Lol...maybe...My simple...very simple answer was, "ASK" the person if they are conscious if they are diabetic for one, and second, ask if they took their insulin recently.

The typical non-medical person isn't going to know the difference between hyper or hypoglycemia. I'm reluctant to shove candy in someone's mouth if they are already hyperglycemic....

I don't think the intructor liked me very much. :chuckle :p :rolleyes:

I am a CDE. If a person is conscious and is hypoglycemic, do not give candy with chocolate in it. Chocolate has fat, which slows down the rise of sugar in the bloodstream.

Here is a link which I think will be helpful to you:

http://www.bddiabetes.com/us/understanding/react_treating_hypo.asp

Stephanie RN CDE

Specializes in Transplant, homecare, hospice.
Hee hee...that poor instructor! :chuckle

Just my humble opinion, but HYPOglycemia, IN GENERAL mind you, is more dangerous than HYPER...I've seen people do ok in the 500's, but seen them drooling and babbling incoherently when they've been in the 60's; I think I'd err on the side of spiking them even higher and get some sugar into them. Of course, it's a supermarket, so maybe you would be able to get ahold of a glucometer...I'm kidding on that one, yeeesh, talk about opening up a Good Samaritan can of worms.

It's a very interesting question, though...I have an uncle in his 70's who is NIDDM and he was telling me on Thanksgiving that lately his symptoms present very similarly whether he's high or low...i.e. lately, he gets the shakes, diaphoresis, confusion, lethargy, and he'll check his BS an it'll be in the 300's!!!!

I'd've loved to have been a fly on the wall during your class, LOL.

LOL....um, it was something straight out of Jerry Springer.:p I think the lady had it in for me. I was really quiet until she mentioned the part about the hyperglycemia and I asked a simple question. I really shouldn't have said anything. Ooops. Live and learn. :chuckle

In my humble opinion as a nurse and a wife of an insulin dependant diabetic: When in doubt assume HYPOglycemia in an emergent sitation.If they rouse then you picked the right course, if not you are no worse off. There is no need in a grocery aisle to use candy ,use the squeeze frosting that is alot like the consistency of the tubes of stuff my hunny keeps on hand.

I agree with this . . . . assuming hypo is the better idea . . . . people can tolerate hyper much better. And using frosting is a great idea or honey. Of course you should never shove something a person can choke on into their mouths.

steph

In my humble opinion as a nurse and a wife of an insulin dependant diabetic: When in doubt assume HYPOglycemia in an emergent sitation.If they rouse then you picked the right course, if not you are no worse off. There is no need in a grocery aisle to use candy ,use the squeeze frosting that is alot like the consistency of the tubes of stuff my hunny keeps on hand.

Isn't Karo syrup very concentrated sugar as well? Wouldn't it take a small amount to do the trick?

Isn't Karo syrup very concentrated sugar as well? Wouldn't it take a small amount to do the trick?

It is but it's also--to use a highly technical term--gloopy. Glutose gel stays where it's put and, although I've never actually used tubed frosting, I would imagine that it behaves similarly. The advantage here is that if there are problems with vomiting or choking, you can actually reach in and wipe the substance off so it doesn't make things worse.

Another thing that you can do is check the purse or pockets (with a witness observing) for a glucagon kit. If you know how to use it, this too, can be life-saving and there are a number of type I's who carry such a kit the way people with allergies carry epi-pens. Even if you aren't familiar with it, a trained dispatcher might be able to talk you through it. The injection isn't complicated. The hardest part is mixing the powder with the the diluent and making sure it is completely absorbed. EMS personnel should carry these as well.

Specializes in LTC.

Forgive me if this sounds ignorant, but I learned in school that honey is actually low on the glycemic index even though it's a monosaccharide, so my instructor advised against using it.

Specializes in LTC.

Too funny. My BLS was done by the AHA and my instructor was hysterical! When I had to practice on the defib, the other students were practicing touching the victim and I started to yell at them to stand back and the instructor rolled her eyes and said (in her Texas accent) "Hey, man, I said large and in charge; not big and a b****!" :rotfl:

Just what I was going to say yvonnemuse. Get the frosting tube. A relative of mine is diabetic and thats how they get.

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