Let’s assume your patient is a female. Begin with the patient lying on her back. Raise her arm closest to you over her head, with her elbow near her ear. Grasp the clothing at her shoulder and hip. As one motion, roll her toward you until she is balanced on her shoulder and hip.
Gently bend this patient’s top knee and allow her to lean against it. This is referred to as the kickstand position, because her bent knee will act to support her body the way a kickstand supports a bike.
A patient can be left in this position no more than 15 minutes. After that, you can position them on their opposite side, using the technique above. Always defer to a position of comfort for a patient who is conscious.
DIABETES
Your body uses sugar much like your car uses fuel. When your car runs out of gasoline, it quits working. Your body does the same when it runs out of fuel! Your brain is the most sensitive organ to changes in sugar levels. Uncontrolled diabetes can lead to other serious medical conditions such as heart disease, stroke, blindness, kidney failure and complications during pregnancy.
Diabetes mellitus is a group of diseases characterized by high levels of blood glucose (blood sugar). Type I diabetes (juvenile onset) develops as a result of the body’s immune system destroying pancreatic cells. Beta cells in the pancreas are responsible for making insulin. Usually children and young adults are affected and may require insulin shots every day. It is estimated that over 150,000 children in the U.S. have diabetes.
Type II diabetes (adult onset) is associated with many factors. Old age, obesity, family history, physical inactivity and race are all being studied as contributing factors for this disease. Studies have shown that interventions of diet control and exercise can reduce your risk dramatically.
HYPERGLYCEMIA (HIGH BLOOD SUGAR)
A hyperglycemic reaction can take several days to manifest. Signs and symptoms include general weakness and a decreased level of consciousness. The patient may have a fruity odor to their breath caused by the release of ketones in the body.
HYPOGLYCEMIA (LOW BLOOD SUGAR)
This condition comes on rapidly with noticeable, immediate effects. This patient will have a profound response that may include profuse sweating, nausea,
62 Central Nervous System
rapid pulse, pale skin, slurred speech, confusion and inappropriate behavior. This can also be confused with a person under the influence of alcohol.
Treatment Options
There are several new and innovative treatment options available to diabetic patients. From pancreas transplants to insulin pumps, these techniques are designed to make this increasing problem more manageable for diabetic patients.
Pancreas transplants have begun to show promise, although the surgery is quite invasive. Improved immunosuppression therapy has made this type of surgery more of an option. Inhalable insulin was approved by the FDA in 2006 and is currently available to some patients, freeing them from daily injections.
An insulin pen is an insulin delivery system that generally looks like a large pen, uses an insulin cartridge rather than a vial and uses disposable needles. Pens are the predominant insulin delivery system in most of the world, except the U.S., where syringes and insulin vials still dominate.
Insulin pumps are another option for the diabetic patient. These are small computerized pumps that match a patient’s insulin needs with their lifestyle and can deliver accurate amounts of the hormone on demand. These devices can help eliminate the highs and lows many diabetics experience.
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