What would you do for hyperglycemia?

[xstreetsweeperx]

What would you do if someone had a blood sugar of 558?>

[chbare]

I'd get more information and verify the findings.

[nypamedic43]

Well according the paramedic textbook, we give them dextrose. Never made any sense to me to do that, but the theory is that giving them dextrose will be usable by the body. In an ER they would get covered with a dose of insulin and then maybe an insulin drip. Out here in the real world, I put them on the monitor and start IV fluids.

While I was in medic school and doing an ER clinical, we had a teenager come in with his mother. She told us that over the last 2 weeks her son wouldnt eat much, had dropped 20 pounds and looked like death warmed over. I checked his BGL and it read hi. A blood test revealed that his BGL was over 1600 and he was diagnosed with new onset juvenile diabetes. He got covered with a dose of insulin and then got an insulin drip and spent 2 weeks in the ICU.

[chbare]

Give dextrose?

[mobey]

Well according the paramedic textbook, we give them dextrose. Never made any sense to me to do that, but the theory is that giving them dextrose will be usable by the body

What textbook?

[tcripp]

Verify. IV. Fluids. Transport to facility with an ICU.

Treat any other symptoms.

[chbare]

I think there may be some confusion over terminology? Assuming somebody has a blood sugar that high, we must recognise that dextrose is the principle sugar our body utilises. There are two forms of glucose. These forms or mirror images are called enantiomers. The forms for glucose are called D-glucose & L-glucose. Humans can only utilise the D enantiomer. Hence, the reason we say we are giving somebody "Dextrose." Dextrose = D-glucose. So, when somebody has an elevated blood sugar, they in fact have an elevated D-glucose or dextrose.

[DwayneEMTP]

Verify, run some fluids if there were no contraindications, transport.

I don't believe that this is an immediate life threat, nor do I think that it requires immediate prehospital intervention.

Or am I off in the ditch somewhere?

[chbare]

We do not know. A number rarely tells us how a patient is doing clinically. You can have a BGL of 500+ and potentially be relatively well compensated or you can potentially be at Death's door.

[hatelilpeepees]

1000 cc of NACL wont hurt anyone (assuming this is an adult patient), I would verify that the patient has the signs and symptoms that correlate with that reading, I have to agree with crotchity on this one, treat the patient, not the machine.