Self Aid

[Just Plain Ruff]

Yeah, Scuba is precisely correct.

What normally happens on scene is this

ARrive, check responsiveness, ABC's and then vitals and then sugar

Usually their sugar says "LO"

If they are semi conscious and can maintain their own airway - give em some OJ with sugar or the glucose paste

if they are unconscious - start an IV and give a syringe full of D-50

Once they come around you then give them something to eat - usually a sandwich and more OJ or something like that.

Recheck their sugar - sometimes it will drop again and you might have to give a 2nd amp of d-50 but usualy not

make em eat another sandwich or better yet, have their wife/husband make em a full meal

IF there's no food in the house (yes some people don't have food in their homes - thus often the cause of their low sugar) you really should transport to the hospital

If they are eating and their sugar is rising, then take out the IV and they can sign a refusal because most diabetics who you get called on refuse transport, but not all do.

There you go, a diabetic ems call in a nutshell

[Caduceus]

@Scuba Thanks for the explanation. In regards to my grandfather, he doesn't keep orange juice around so would some other powdered, sugary drink work? Like lemonade? The guy is super stubborn and doesn't carry his pills, and I don't know where they are, so I'll have to improvise any traditional treatments. There's usually peanut butter/some kind of choco in the house tho somewhere. What about ice cream? They have that.

@Capt Hey thanks for the walk through! Interesting. Yeah I can see them not wanting transport makes sense. Hey that's smart about the bug out bags. Medical conditions make prepping a helluva lot more difficult. And no kidding about never being too safe; plus it's smart to teach your kids how to take care of dear ol' dad. I can't think of something more scary than knowing my dad was sick and not being able to take care of him. If you're like me for a while after you grabbed the wrong thing you probably compulsively checked that you gave yourself the right kind, eh?

What kind of public health nurse walks into a first aid class and says, "I have a cold, so it's gonna give your immune systems a work out." There was a baby. A BABY!

[scubanurse]

Lemonade would be good...anything with a high sugar content and then load some carbs and protein in there to maintain the BGL.

[Caduceus]

Ah okay! I'm just kind of hoping that we don't have to have this problem. . .preferably ever. He is pretty good about eating when he needs to. But he works a lot outside so his liquids can get pretty low sometimes. At least it's not as bad in the winter.

[Just Plain Ruff]

CAd, I would suggest that your family put together a bag of items that would help Dear old Granpa out in an emergency. Bottled water and sugary drink mixes, quick easy sugar fix, Peanut butter jar, jelly jar and some wrapped crackers, you can whip up a quick PB&cracker sandwich for him.

Get some of the sugar replacement pills that they have at CVS or Walgreens in the diabetic Aisle and also get some chocolate and or other types of candy. Buy a cheap cooler or tote for all the items and you should be fine. None of the items will go bad in the bag unless you let them go past their expiration date.

One other thing,you should put together a medical sheet with his medications, medical history and allergies to give to the EMS crews if you ever have to call them. Doing this NOW will keep you from forgetting something important about his history/meds when you are super stressed when and if he ever goes down unresponsive.

Put that medical sheet in a ziplock bag and seal it so if anything spills in the bag of grandpa's diabetic stuff, you have a sealed container that won't get wet.

Make sense?

[Caduceus]

Okay! That's pretty easy and really useful on trips away from home, as well as when I'm up there with him by myself. I'll be sure to do this next time we get into a grocery store or Walmart.

The medical sheet is the best idea I've heard all day. I will do this for both my grandpas since they're both on so many medications I don't even know all of them. If either of them had a stroke or heart attack (God forbid) I'd definitely need that for the EMS crew. I trust myself not to do something stupid in an emergency but as you said I wouldn't be able to remember all their meds in that kind of situation.

It does, thanks a bunch! You're a huge help >///<

[iStater]

We advise against peanut butter because it is mostly protein and fat with very little carbs as frontline. It also can present some aspiration risks in some age groups or varying mentation. Chocolate is also not advised because it contains too much fat to effective raise the glucose levels. The same for whole milk and cheese. Protein and fat can hinder the glucose levels rising as they are needed to.Later after something which will effectively raise the glucose level would be okay. Glucose gel, skim milk, juice and even regular soda are front line.

The medical sheet is the best idea I've heard all day. I will do this for both my grandpas since they're both on so many medications I don't even know all of them. If either of them had a stroke or heart attack (God forbid) I'd definitely need that for the EMS crew.

Most hospitals and physician offices are now required to update their electronic medical record system for uniform reporting and record keeping. Hospital and physicians should be able to generate a list of all the medications and pertinent medical history. Make copies but also remember to discard the old ones as the med list gets updated. You can also take a photo of these pages and store on your smart phone and a cloud for easy access.

Paramedics should also not take time on the scene to copy the entire list (or bag of med bottles) and medical history while deferring transport. Bring them in. We found meds which have been copied by Paramedics to have not been used in 10 years or they weren't even the patient's meds. They just happened to be on that counter or cabinet at that time with the others. Please be careful and when you can, advise the patient to get a copy of their current med list when they are discharged from the ED or hospital. Many computers now talk to each other and this is possible.

Edited October 25, 2013 by iStater

[Just Plain Ruff]

We advise against peanut butter because it is mostly protein and fat with very little carbs as frontline. It also can present some aspiration risks in some age groups or varying mentation. Chocolate is also not advised because it contains too much fat to effective raise the glucose levels. The same for whole milk and cheese. Protein and fat can hinder the glucose levels rising as they are needed to.Later after something which will effectively raise the glucose level would be okay. Glucose gel, skim milk, juice and even regular soda are front line.

Thanks IStater, I'd much rather not do the glucose gel. I'll take a look at my kit the next couple of days. Funny thing is that the peanut butter and jelly was a suggestion from my Endocrinologist.

Cad, seems that you may have been on to something but in my case, my sugar came back up without an issue after the Pb&J's and the chocolate/milk as well. It stayed just fine for the rest of the evening.

So let's pull this out a little and let's put a kit together then.

What would the group recommend that I put in my kit - to replace my Pb&J??

I do NOT want to put in the glucose jelly but I will purchase a tube or two when I go to CVS in the next week or so though.

Suggestions wanted: But remember, the items have to have a long shelf life and they have to be able to be put together by either myself who's sugar may be low but not low enough to be unconscious or they have to be able to be put together by a 11 year old or a 4 year old (I would just tell my little girl to go get daddy's diabetic kit)

Thankfully my sugar only goes that low when I make a ID10T mistake like the other night.

[iStater]

I would say the jelly played a role in getting the glucose up quickly. The milk also if low fat or skim. The pb might be good for stabilizing. But, for digested purposes and a quick response, pb and chocolate would not be the best. ENSURE, which is commonly found in hospitals or long term facilities, is also not the best to give.

[Just Plain Ruff]

We advise against peanut butter because it is mostly protein and fat with very little carbs as frontline. It also can present some aspiration risks in some age groups or varying mentation. Chocolate is also not advised because it contains too much fat to effective raise the glucose levels. The same for whole milk and cheese. Protein and fat can hinder the glucose levels rising as they are needed to.Later after something which will effectively raise the glucose level would be okay. Glucose gel, skim milk, juice and even regular soda are front line.

Most hospitals and physician offices are now required to update their electronic medical record system for uniform reporting and record keeping. Hospital and physicians should be able to generate a list of all the medications and pertinent medical history. Make copies but also remember to discard the old ones as the med list gets updated. You can also take a photo of these pages and store on your smart phone and a cloud for easy access.

Paramedics should also not take time on the scene to copy the entire list (or bag of med bottles) and medical history while deferring transport. Bring them in. We found meds which have been copied by Paramedics to have not been used in 10 years or they weren't even the patient's meds. They just happened to be on that counter or cabinet at that time with the others. Please be careful and when you can, advise the patient to get a copy of their current med list when they are discharged from the ED or hospital. Many computers now talk to each other and this is possible.

Yea IStater, I work on a project where one of our key measures is making sure that the ED clinicians have all the tools that they need in the medical records system (EPIC) that I give them, to be able to do just what you say on the medical history and medications. For those who do not know the terms it's called medication reconciliation.

When the meds are reconciled, they are compared with what is in the hospital system to what the patient says they are taking, this occurs in triage or during bedside triage. Once the patient is discharged, they may be given prescriptions, so the nurse is required to reconcile again the meds with the prescriptions. Can you say that nurses don't like this process - you bet your sweet patootie that they don't like this process, the common complaint I hear is "It takes to much time" But unfortunately it's not my fault that they have to do this, it's one of the great mandates that have come down from above.

But anywho, Yes, the best med list/history list is going to come from the most recent ER visit as long as the nurses in that ED/Hospital are doing the required steps and doing the med reconciliation. You can just take that shieet that they give you and put it in the kit.

Any time the patient gets a new drug or prescription refill it's a good idea to update the list to make sure things are good to go.