2010-2011
PCP
Recertification
Pre-Course: Diabetic
Emergencies
Diabetic Emergencies - Overview
•
•
•
•
•
Objectives
Anatomy & Physiology
Etiology
Hyperglycemia & Hypoglycemia
Pharmacology
Objectives
Given pre-course reading and Webinar, small group discussion
of various case studies, a manikin, and medical equipment,
the paramedic will be able to:
•
•
•
•
Explain the etiology and pathophysiology of diabetes mellitus.
Describe and identify the common signs and symptoms of both
hyper and hypoglycemia.
Summarize the pharmacokinetics and pharmacodynamics of
Glucagon and Dextrose.
Describe and demonstrate the proper application of the Altered
LOC – Suspected Hypoglycemia Protocol, and (if certified), the
Intravenous Access & Fluid Administration Protocol.
As evaluated by the facilitator during case presentations, skill
stations, oral scenarios, and a written evaluation.
Anatomy & Physiology
Pancreas
•
•
•
Endocrine & Exocrine gland
Releases Insulin from Beta cells
Releases Glucagon from Alpha cells
Etiology
Type I
•
•
No/Little insulin production
Insulin dependant
Type II
•
•
Insulin production – too little, or improperly utilized
Manageable with diet/oral meds
Gestational
•
•
•
Similar to Type II
Pregnancy causes decreased sensitivity to insulin
Manageable with diet/insulin
Hyperglycemia & Hypoglycemia
Hyperglycemia
•
•
•
No immediate life threat
Typically undiagnosed
Acetone (fruity) breath
Hypoglycemia
•
•
•
Life threatening emergency
Insulin shock
Low blood sugar
Hyperglycemia & Hypoglycemia
Hyperglycemia
•
•
•
Acetone breath
Dehydration
Excessive thirst
Hypoglycemia
•
•
•
Altered LOC
Behavioural changes
Cool, clammy, diaphoretic
Pharmacology
Glucagon
•
•
•
•
Hormone
Stimulates breakdown of liver glycogen
Raises serum glucose levels
IM only
Pharmacology
Dextrose
•
•
•
•
Carbohydrate substrate (hypertonic)
Hyperglycemic
Osmotic diuretic
IV only
Questions ?
Contact SWORBHP
• 519-667-6718
• [email protected]
References
•
•
•
•
•
•
•
Aehlert, B. (2010). Paramedic Practice Today – Above and Beyond
Volume, Endocrine Emergencies and Nutritional Disorders, 24, 947-973
Adler, J., & Plantz, S. (1998). Endocrine Emergencies and National
Disorders, National Medical Series for Independent Study, Emergency
Medicine, 8, 247-262
Beck, R. (1994). Metabolic Emergencies, Pharmacology for Prehospital
Emergency Care 2nd Edition, Philadelphia, PA. F.A. Davis Company
Bledsoe, BE., Porter, RS., Cherry, RA., & Clayden, DE. (2006) Essentials
of Paramedic Care, Canadian Edition. Toronto, Ontario. Pearson
Prentice Hall Inc.
Diabetes Facts (2010). Retrieved June 8, 2010, from
http://www.diabetes.ca/about-diabetes/what/facts/
Guy, JS. (2010). Pharmacology for the Prehospital Setting, Endocrine
Emergencies, 11, 185-198
The Prevalence and Costs of Diabetes (2010). Retrieved June 8, 2010,
from http://www.diabetes.ca/about-diabetes/what/prevalence/