Diabetic OPQRST

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Youn0469

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Today I was in scenarios practicing for my EMT practical exams when my instructor gave me a diabetic scenario.

The skinny is 30yo Female who is hypoglycemic, blood glucose level of 64. The pt is alert and oriented x3, her signs mimic that of a drunk pt. I administer glucose and proceed on with my assessment. I get to history of present illness and I am trying to rack my brain to think of questions for OPQRST.

The only one I can think of to ask is "what is the last thing you remember?"

What are some things you might ask? How have you handled diabetics in the past? I'm almost betting that I will see something close to diabetic emergency on my practical because the instructors are really hitting it hard.
 
Last time you ate?
What did you eat?
What meds do you take?
When did you take them?
Did you take them?
Has this happened to you before?
How often?
Here, eat this.
Yes, you have to.

Then just monitor and reassess as you wait for their glucose to normalize.

OPQRST doesn't really fit with a hypoglycemic. It's more geared towards getting information on a pain or complaint (I think I worded that poorly, but you get the gist).
 
While OPQRST is a great tool to use for assessing pain, it's not great for altered mental status. You can ask the onset question to a bystander, but don't expect to gain any useful info from your altered patient.

It'll go something like this:

You: so, when did this start?
Patient: grrraaahhh.
Bystander: she took her insulin about 20 minutes ago.
You: ahhh. Here's some glucose.

See? The other OPQRST questions simply aren't relevant.
 
Thanks,
That's the beauty of learning I guess!

I hit most of the questions through SAMPLE that were given above. I felt like OPQRST was pretty much irrelevant after onset but felt I had to go through it for the point factor.

Now I know what I need to change for next time. I'll also make the 15 minute mark.
 
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