I almost died laughing after checking my patient's blood sugar.

abckidsmom

abckidsmom

Dances with Patients
Messages
3,380
Reaction score
5
Points
36
I guess I spent too much time around here this week, cause last night I went for a lady who had a syncopal episode in the bathroom then was too weak to get up.

The family said she'd been driving them crazy with getting up going to the bathroom at night and she'd been so thirsty the whole week. She had been unable to eat, and now she was slightly short of breath and dizzy.

We checked her blood sugar, and while my partner was sticking her finger, I said, I bet it'll say "HI".

Sure enough, it did. And I didn't even have a health history form. In fact, she had not been to a doctor since 2001, so there was no documented medical history.

New onset diabetes, party of one. DKA section, please. :)
 
Both my diabetic patients died this week. But then again, both said "Lo" :ph34r:
 
"I think the meter is trying to have a conversation with me?"
 
Obviously since your also a RN, you can discern that prior to a FSBGL. Us lowly paramedics on the other hand, would have been lost :ph34r: :D.
 
How did you know to check without a history? Dang girl, youre good!
 
polydipsia, polyuria. I thought the same thing within the first few sentences.


another clue would have been that the urine on the floor would be sticky enough to allow you to walk on the walls...
 
8jimi8 said:
polydipsia, polyuria. I thought the same thing within the first few sentences.


another clue would have been that the urine on the floor would be sticky enough to allow you to walk on the walls...
Click to expand...


Hey wait a minute, there was no mention in the story of urine on the floor. The nurse did not tell you that there was urine on the floor. However did you know that? ;)
 
He is a nurse. He knows these things.
 
epipusher said:
differential dx? learn me some more
Click to expand...

Serious question? Hope so.

Middle of the night syncope always brings to mind cardiac events and CVA.

This lady, with her weakness, and apparent comfort and happiness to lay in the floor for 2 hours made me really lean toward CVA until I started talking to her and the family. I could have been hyper-focused on my suspicions, but with the weakness, polyuria, polydipsia, tachycardia, tachypnea, and obesity, with long periods without medical care, there was really nothing else I suspected.

I wondered whether it was HHNK vs DKA, but when her ETCO2 was 80, that settled that.

Funny enough, I told the story to the ED on the phone, with the opening line being "64 yof with possible new onsent diabetes, possibly in DKA" and then filled in the story a little. When we got there, with her in a gown, having had a liter bolus and the second one started, with a cohesive story, they thought we were doing an IFT from an outlying facility who must have forgotten to call. They were confused when they finally understood she was coming from home. "How did you get all this information?"

Clinical assessment. And this was a clear cut one.
 
don't all these stories end the same?

6 firefighters had to unwedge her from the door frame of the bathroom, yet you get to load the stretcher in the rig by yourself... meanwhile the urine is making the gravel stick to your boots like candied popcorn....
 
8jimi8 said:
don't all these stories end the same?

6 firefighters had to unwedge her from the door frame of the bathroom, yet you get to load the stretcher in the rig by yourself... meanwhile the urine is making the gravel stick to your boots like candied popcorn....
Click to expand...

We called for a lift assist, and had an old guy and a clueless girl who'd been on the VFD for 3 weeks show up. Super helpful.
 
8jimi8 said:
polydipsia, polyuria. I thought the same thing within the first few sentences.
Click to expand...

This. Also, that House episode where he can't pee and the girl in the clinic is drinking copious amounts of water due to her new onset diabeetus :P
 
Just remember that DM isn't the only thing that can cause polydipsia/uria.
 
JPINFV said:
Just remember that DM isn't the only thing that can cause polydipsia/uria.
Click to expand...

usalsfyre said:
Yep, so can DI :D.
Click to expand...

poly/poly with wasting and anorexia combined with CBG of HI was pretty convincing.

Nothing I would have done differently, except be wrong, lol.

I think DI is one of the most poorly named diseases out there. How did they label that with diabetes???
 
You must log in or register to reply here.
Back
Top