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Flying

Flying

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RobertAlfanoNJEMT said:
No I meant what I wrote... Hyperglocimia is blood sugar that's too high... We are told to give oral glucose to all patients in a diabetic emergency hyper or hypoglycemic!
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That is the wrong way to go about it. We can certainly say that you were taught incorrectly.

In a true diabetic emergency, grossly hyperglycemic and hypoglycemic patients present very differently and one should be able to tell between them through the basic exam and treat differently based on this. If you don't know the very basics such as these, then you have no business to be talking about having glucometers.
 
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RobertAlfanoNJEMT

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Flying said:
That is the wrong way to go about it. We can certainly say that you were taught incorrectly.

In a true diabetic emergency, grossly hyperglycemic and hypoglycemic patients present very differently and one should be able to tell between them. If you don't know the very basics such as these, then you have no business to be talking about having glucometers.
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The exact words from one of my instructors who had over 30 years of experience riding in a large city was "you can't hurt by giving oral glucose so give it"
 
NomadicMedic

NomadicMedic

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Well, the basic curriculum does say to administer glucose to a patient "having a diabetic emergency". An altered patient, with a history of diabetes would most likely be hypoglycemic.

I guess they figure a tube of glucose will help a hypoglycemic and won't really hurt a hyperglycemia patient any worse. Like most of the EMT education, when the only tool you have is a hammer, everything looks like a nail.
(See also: spinal immobilization)
 
CALEMT

CALEMT

The Other Guy/ Paramaybe?
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RobertAlfanoNJEMT said:
No I meant what I wrote... Hyperglocimia is blood sugar that's too high... We are told to give oral glucose to all patients in a diabetic emergency hyper or hypoglycemic!
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Umm you are aware that one of the contraindications for oral glucose is a BLG >60 right? Even without a glucometer you should be able to tell which pt has a high BGL and which has a low BGL.

A person with a high BGL certainly doesn't need even more glucose within the body. Theres a reason that medications have contraindications and one of them for oral glucose happens to be a BLG >60. Even without a glucometer you can tell who needs glucose and who doesn't.

If you remember from EMT school the body needs two things to maintain blood sugar homeostasis: insulin and glucagon. Insulin levels (in the body) naturally rise when blood glucose levels rise (ex. eating a meal). Cells within the body respond to this by taking glucose from the blood, and as a result you lower the blood glucose level. Now on the other side of things glucagon is secreted when the body's blood glucose levels are to low (ex. you skipped a meal). Glucagon's job is to help the liver release stored glucose and whaha blood glucose levels rise. Same concept applies to the prehospital world, when sugar is low you give more sugar. When sugar is high you don't give more sugar.
 
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RobertAlfanoNJEMT

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CALEMT said:
Umm you are aware that one of the contraindications for oral glucose is a BLG >60 right? Even without a glucometer you should be able to tell which pt has a high BGL and which has a low BGL.

A person with a high BGL certainly doesn't need even more glucose within the body. Theres a reason that medications have contraindications and one of them for oral glucose happens to be a BLG >60. Even without a glucometer you can tell who needs glucose and who doesn't.

If you remember from EMT school the body needs two things to maintain blood sugar homeostasis: insulin and glucagon. Insulin levels (in the body) naturally rise when blood glucose levels rise (ex. eating a meal). Cells within the body respond to this by taking glucose from the blood, and as a result you lower the blood glucose level. Now on the other side of things glucagon is secreted when the body's blood glucose levels are to low (ex. you skipped a meal). Glucagon's job is to help the liver release stored glucose and whaha blood glucose levels rise. Same concept applies to the prehospital world, when sugar is low you give more sugar. When sugar is high you don't give more sugar.
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Yes I know all of that.. I just finished a year of anatomy and physiology but thanks for the lesson! With out testing the glucose level you cannot be CERTAIN if it is hypo or hyperglycemia... All patients are different and react differently to what is going on in their body..
 
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RobertAlfanoNJEMT

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My father is a diabetic and has gone to the hospital via ambulance 2 or 3 times for hyperglociamia.. It's not always hypoglycemia don't put those blinders on guys!
 
EMT2015

EMT2015

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RobertAlfanoNJEMT said:
As for the troll part stop acting like a middle school adolescent who was just given a keyboard and wifi connection
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Buddy, you really need a attitude adjustment. I have been watching this thread for a little while now and have not said anything. But, I have gotten tired of seeing you disrespect everyone on here who are only trying to help you learn. I completely agree with a lot of people on here that you have been taught incorrectly and to be honest it feels like you think that you know it all. Take a note from someone who's still new to the EMS field, what you learn in class and what you learn in the field can be completely different sometimes. My advice is that you start listening to everyone here who has tried to help you learn the correct information. As your peer, I will be completely honest and say that I fully believe that you are not ready for the streets and need to do some more research.
 
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RobertAlfanoNJEMT

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EMT2015 said:
Buddy, you really need a attitude adjustment. I have been watching this thread for a little while now and have not said anything. But, I have gotten tired of seeing you disrespect everyone on here who are only trying to help you learn. I completely agree with a lot of people on here that you have been taught incorrectly and to be honest it feels like you think that you know it all. Take a note from someone who's still new to the EMS field, what you learn in class and what you learn in the field can be completely different sometimes. My advice is that you start listening to everyone here who has tried to help you learn the correct information. As your peer, I will be completely honest and say that I fully believe that you are not ready for the streets and need to do some more research.
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Seriously dude? I've been the one being attacked this whole time... I was called a troll, they were saying that since I'm in NJ I don't know what I am talking about etc etc.. I aprieciate people who try to help me but not people who are going to be rude in the process.. I will not stand for being attacked and called unintelligent when most of the people saying it have not a whole lot more education than me. I may be new to the EMS life but I am not new to medicine.. I have been researching medicine, the way the body reacts, and anatomy and physiology for most of my life. As well as volunteering in a local ER... I know my **** and am willing and thirsty to learn more if people are willing to be respectful and not talk down to me!
 
Carlos Danger

Carlos Danger

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RobertAlfanoNJEMT said:
Seriously dude? I've been the one being attacked this whole time... I was called a troll, they were saying that since I'm in NJ I don't know what I am talking about etc etc.. I aprieciate people who try to help me but not people who are going to be rude in the process.. I will not stand for being attacked and called unintelligent when most of the people saying it have not a whole lot more education than me. I may be new to the EMS life but I am not new to medicine.. I have been researching medicine, the way the body reacts, and anatomy and physiology for most of my life. As well as volunteering in a local ER... I know my **** and am willing and thirsty to learn more if people are willing to be respectful and not talk down to me!
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Either the worst trolling or the awesomest Ricky Rescuing I've seen in a while. Either way, rather entertaining.
 
teedubbyaw

teedubbyaw

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CALEMT said:
Even without a glucometer you can tell who needs glucose and who doesn't.
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Robert does have a valid point. An old frame of mind/practice was giving glucose to altered pt's with a possible history of diabetes. Both hypo and hyperglycemia can present similarly, and a BLS provider without full understanding of the pathophysiology behind both processes, may not be able to differentiate the two between signs/symptoms.
 
EMT2015

EMT2015

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RobertAlfanoNJEMT said:
may be new to the EMS life but I am not new to medicine.. I have been researching medicine, the way the body reacts, and anatomy and physiology for most of my life
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One question: Your profile says that you're 18, so how can you have been doing this for most of your life?
 
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RobertAlfanoNJEMT

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teedubbyaw said:
Robert does have a valid point. An old frame of mind/practice was giving glucose to altered pt's with a possible history of diabetes. Both hypo and hyperglycemia can present similarly, and a BLS provider without full understanding of the pathophysiology behind both processes, may not be able to differentiate the two between signs/symptoms.
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Thank you!
 
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