Oral Glucouse

DrParasite

The fire extinguisher is not just for show
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Unless you are a member of law enforcement (and even then it's questionable), New Jersey Dept of Health no longer has a first responder program.

If you are a first responder certified person in NJ, you are certified by the National Safety Council or some other random agency, not the NJ agency that sets regulations for EMTs and Paramedics.
 

workworkwork

Forum Probie
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after thinking about this scenario a bit more it rubs me the wrong way.

a first responder administering glucose during a sporting event for an unknown medical issue for a non diabetic?
 

mycrofft

Still crazy but elsewhere
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Like "Here, want some Gatorade?".:rofl: Am Red Cross lay first aiders can administer food or orange juice (where did that fixation come from, OJ....?).
Harmless in and of itself, except unless it signals a willful departure from protocols. Then it could become handing out sunscreen, or allergy tablets, or splinting for no good reason. Sort of "Glucose as a gateway drug".

Or if they have dumping syndrome.
 
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musicislife

Forum Crew Member
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idk, thats what my friend did (there was no gatorade around, just water) worked just fine, because the pt was experiencing signs of hypoglycemia
 

medichopeful

Flight nurse, ground paramedic
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idk, thats what my friend did (there was no gatorade around, just water) worked just fine, because the pt was experiencing signs of hypoglycemia
I'm not second guessing what was done, but one thing that must be considered when treating someone is that many signs or symptoms of one disorder or disease are also signs and symptoms of another.
 

Tigger

Dodges Pucks
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idk, thats what my friend did (there was no gatorade around, just water) worked just fine, because the pt was experiencing signs of hypoglycemia
Signs of hypoglycemia do not by themselves indicate that some is suffering from hypoglycemia though. Maybe the person's sugar was low and that's what they needed or maybe they felt better because some gave them a medication. Personally I think it's a rather poor practice to give glucose to anyone potentially showing signs of hypoglycemia. No drug is benign and while it's likely that there were no ill effects in this particular case, how about calling for EMS next time and getting a BGL and a more proper assessment?
 

mycrofft

Still crazy but elsewhere
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OP can't get a blood glucose, he's a first aider or first responder. Some glucose (not a big bolus of D50 or whatever, just some OJ like the red cross says?) is not going to hurt unless the pt vomits it back up while lying down and it embarrasses the airway.

OP, what were the pt's complaints which led your friend to give the runner something to drink or eat that suggested hypoglycemia?

Again, some sugar unless it affects airway (obtunded pt) is not going to hurt the pt, maybe/unless they are experiencing dumping syndrome (ask if they get it, if they have had a gastric bypass, etc).
 

Tigger

Dodges Pucks
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OP can't get a blood glucose, he's a first aider or first responder. Some glucose (not a big bolus of D50 or whatever, just some OJ like the red cross says?) is not going to hurt unless the pt vomits it back up while lying down and it embarrasses the airway.

OP, what were the pt's complaints which led your friend to give the runner something to drink or eat that suggested hypoglycemia?

Again, some sugar unless it affects airway (obtunded pt) is not going to hurt the pt, maybe/unless they are experiencing dumping syndrome (ask if they get it, if they have had a gastric bypass, etc).
I realize that, hence "call EMS" ;).

The sugar might be harmless, but that doesn't need we need to be giving medications to patients just because we can.
 

musicislife

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I believe she was acting strange. She noticed an improvement to the pt's condition, so thats probably why she didnt radio for the rig to come over.
 

mycrofft

Still crazy but elsewhere
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Tigger's right

I'd call "the rig" for any alteration in behavior like that. Could drink your OJ, say "Thanks", stand up then collapse with a stroke, or a bad heart valve, or heat exhaustion, etc etc. Altered LOC is a reason to call in the cavalry.
 

Epi-do

I see dead people
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Given the right circumstances, anyone's blood sugar can become low. However, when this happens to most people, once they begin feeling off, "funny", or what have you, they think to themselves, "Wow! I don't feel right! I really need to eat something," and get something to fix the problem.

As for seeing a patient that is a "non diabetic" - it could be that they have yet to be diagnosed. It could just be that someone didn't eat soon enough after already running on empty and then doing strenuous activity. It could be something else completely.

The endocrine system is very complex, and there could be countless factors playing into a random, one-time episode of low blood sugar.
 

Akulahawk

EMT-P/ED RN
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what are the odds of coming across a patient who is a non diabetic with hypoglycemia? How would this occur?
Given the right circumstances, anyone's blood sugar can become low. However, when this happens to most people, once they begin feeling off, "funny", or what have you, they think to themselves, "Wow! I don't feel right! I really need to eat something," and get something to fix the problem.

As for seeing a patient that is a "non diabetic" - it could be that they have yet to be diagnosed. It could just be that someone didn't eat soon enough after already running on empty and then doing strenuous activity. It could be something else completely.

The endocrine system is very complex, and there could be countless factors playing into a random, one-time episode of low blood sugar.
I'm not a diabetic... but I know the feeling of running low. Basically, I just don't feel right and I have to eat something that is sweet. I've never had my blood sugar tested during those moments, but it's pretty clear that I'm starting to get low. It used to happen more frequently when I was far more active and I'd burn off a lot of my body's glucose and "bonk." The symptoms I have when I run low are very similar to when I bonk. When I get to that point, I am still in full control of my faculties, and I seek out a sugary drink and then seek out something with protein.

That's before I start to run really low and get into the agitation and nervousness...
 

Akulahawk

EMT-P/ED RN
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Altered LOC in the setting of heat illness should really drive up your suspicion of heatstroke. Heat exhaustion and heatstroke can blend together so you might see more signs of one and not the other until the patient is well into heatstroke.

What gets fun figuring out is when your patient is exhibiting signs of heat exhaustion, heatstroke, and is bonking because of athletic activity...
 

mycrofft

Still crazy but elsewhere
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But in this OP's case, just call for reinforcements, get the pt cooled off, and don't do anything rash like giving oral anything to someone who is losing consciousness.
I found an article about hypoglycemia per se (not as a diabetic affect exclusively) and posted it elsewhere tonight.
 

Christopher

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I believe she was acting strange. She noticed an improvement to the pt's condition, so thats probably why she didnt radio for the rig to come over.
After a race they likely are hypoglycemic, dehydrated, and somewhere on the heat exhaustion scale...

Water, electrolyte replacement, some carbs and maybe some sugar. Move them to a cool place.

Do they need EMS? I've worked some iron distance triathalons and my notion of "big sick" versus "little sick" got quite the shock. Simple AMS that doesn't improve with rest, rehydration, and food is probably going to concern me...otherwise they'll be fine.
 

Tigger

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After a race they likely are hypoglycemic, dehydrated, and somewhere on the heat exhaustion scale...

Water, electrolyte replacement, some carbs and maybe some sugar. Move them to a cool place.

Do they need EMS? I've worked some iron distance triathalons and my notion of "big sick" versus "little sick" got quite the shock. Simple AMS that doesn't improve with rest, rehydration, and food is probably going to concern me...otherwise they'll be fine.
Agreed, many athletes at the end of any sort of race are going to be a mess. We have NCAA cross country race every year and it's always a mess at the finish line; AMS, vomiting, Asthma attacks, dehydration, heat exhaustion, the works. Most of this clears up relatively quickly, but if you're working an event like this you need to be prepared to manage a patient that doesn't come around. I'd argue that a single first responder is likely not capable of this. At our race we have 5-6 EMTs, an athletic trainer, and 3-4 aides that help us move people into treatment areas. We have a medic unit posted nearby as well.
 

Brandon O

Puzzled by facies
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DeepFreeze

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i try!

i actually had to lookup what D50 is, as we don't have that in MA, at least not at my company.
Not to derail but...but I've seen it refereed to that both on the northshore (lynn specifically) and in Metro-Boston at two different ambulance companies.
 
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