Treatment
The recommended first aid treatment for the diabetic patient can be summed up with one word: SUGAR! Giving sugar to a hypoglycemic patient often has a dramatic and nearly immediate effect. It allows the brain to quickly receive its much needed energy source and can begin to relieve symptoms quite quickly. If your patient is able to hold a cup, give oral sugar. Take a few ounces of orange juice (any liquid will work) and add 10 tablespoons of sugar. It seems like a lot, but this amount of sugar works nicely. Have the patient slowly drink it and monitor their condition carefully.
Don’t place anything in the mouth of a patient who is unconscious. Liquids, candy or other foods may cause an airway obstruction. Instead, rub a small amount of glucose, frosting or sugar paste (sugar mixed with a small amount of liquid) between the cheek and gum of your patient. This hastens the absorption of the sugar and begins to wake the patient.
Once the patient wakes up, a longer-term source of fuel is needed, such as complex carbohydrates and proteins like peanut butter, meat or cheese. The patient will probably need to check blood sugar levels at this time. It is certainly a good idea to call the PIC and Aircare Access for a severe diabetic emergency. If someone has gone unconscious from low blood sugar, brain damage is a concern.
Hyperglycemia is nearly impossible to tell apart from hypoglycemia in the first aid setting. The treatment will be the same. Giving the hyperglycemic patient more sugar will not cause harm. If, after giving sugar, the patient doesn’t begin to wake up, look for other causes. Look for things such as airway obstruction, seizure, heart attack, etc. Continue to manage the airway and place the patient in the recovery position.
FEVER
Although there are some variations from person to person, normal body temperature is around 98.6 degrees Fahrenheit (37 Celsius). A rise in temperature above 100.4 (38) is referred to as a fever. Fever is a normal part of the body’s defense against infections. A fever that goes too high or rises too quickly can cause a person to have a change in level of consciousness. This is especially true in children and infants.
Fever with a stiff neck, headache, skin rash or change in level of consciousness can be a cause for concern. A patient who is hot to the touch, may complain of being cold or having chills. The feverish patient may also shiver.
Central Nervous System 63
One way to estimate the extent of a fever is to place your hand on the patient’s forehead. Compare the temperature of the patient’s skin to your own. If your patient feels extremely hot, help remove excess clothing or consider cooling with lukewarm water. A fever is likely the result of an infection and it’s not important to identify the underlying cause. Testing in the hospital can determine the problem. Often, over-the-counter medications can help relieve a fever. Aircare Access may request you offer these to your patient.
SKIN VITALS
The temperature and quality of a patient’s skin can tell much about their overall health. This is one of the vital signs you need to obtain in any medical emergency. Pull your glove off slightly and using the back of your hand, feel the patient’s forehead. You should be feeling not only for the temperature of the skin, but also for moisture or dampness.
Gauge the patient’s temperature by comparing it to your own. If you have a thermometer, use it to obtain an accurate temperature and note it on the Access Call Sheet. Is the patient warm and dry or cool and clammy? A patient who is seriously ill will also take on a less-pigmented skin tone. For the patient’s ethnicity, note any changes to the skin color.
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