Monday, November 21, 2011
Dianna's back for her monthly guest blog. Today, she covers EMS care for a diabetic emergency.
EMS 4 diabetic emergency at 123 Fox Street, at
I stuff the rest of my sandwich into my mouth and gulp down some water as I rush out of the fast food joint to hop into my ambulance. As my partner signals RESCOM (dispatch) we’re en route to the above (sample) call, I speed our ambulance down the road, lights and sirens.
I won’t discuss the full assessment and treatment we’d perform on a diabetic patient, but if you want clarification or further explanation for your fictional writing needs, please ask me.
On scene we find first responders assisting an unconscious male sitting slumped over in a Target bathroom.
“His blood sugar is 12,” one of the firefighters tells me. “He works here and his co-workers say he takes insulin daily.”
“Sir?” I say to the patient. “Can you hear me?”
No response. His eyes are half open. His pupils are dilated and sluggish.
My partner and I insert a line (IV), and push one 25g AMP (ampule) of D50 (dextrose 50% in water). I attach him to our cardiac monitor via a 12-lead (ECG patches), and assess his heart rhythm and all his vital signs. He’s in normal sinus rhythm and all his vits are within normal range; however he’s slightly tachycardic (heart rate too high), but an elevated HR is the body’s defense to survive a hypoglycemic episode (low blood sugar).
“Sir?” I place my hand on his shoulder. “Hey, buddy, talk to us.”
The patient remains unresponsive, so my partner and I push another 25g AMP of D50.
Via a glucometer, we test his BGL (blood glucose level). It’s now 43. We’re headed in the right direction, but the patient is still unresponsive. We administer 1mg of glucagon IM (intramuscular injection).
“Sir?” I squeeze his hand. “I need you to talk to me. Okay?”
He stirs, his eyes attempt to focus. We load him onto our stretcher and wheel him inside our ambulance. Within a few minutes, he stares at me. “Where am I?”
“You’re in an ambulance, sir. I’m EMT Benson.” I finish retaking his BGL again. It’s now 98 (within normal limits). “Do you know what happened?”
He nods. “Yeah. It happened again. Twice this week. Stupid blood sugar.”
Can you tell me your name?” I ask, even though I know his personal information via his co-workers. I start this line of questioning to assess the patient’s mental status.
“Okay. Bob, what’s your birthday?”
“Ah…February 3, 1972.”
“Uh-huh. Gosh, Bob, my math is horrible. How old does that make you?”
“Thirty-nine, but don’t tell my girlfriend. She thinks I’m thirty-one.”
I laugh. “I won’t say a thing, but you may want to tell her yourself soon, what do you think?”
“You’re probably right.”
“You take insulin, I hear. Did you take any today?”
“45 units, early this morning.”
“45, huh? Have you eaten anything today?” I note the time is twenty minutes past noon.
“Two graham crackers.”
“You need to eat more than that, you know? Especially after 45 units. Breakfast is the most important meal of the day. Promise me you’ll eat breakfast everyday.”
He nods as he smiles at me.
I radio the hospital. “Wake Med,
EMS 4 en route with pt (patient) initial BGL 12, then 43, now 98. We’ve given 2 AMPS of 25g D50, and 1 mg of glucagon. Initially pt was unresponsive, now A&O times 4 (alert and orientated times 4). Vitals within normal limits. ETA 2 minutes.”
“ED room on arrival. Wake Med out.”
EMS 4 out.”
After majoring in communications and enjoying a successful career as a travel agent, Dianna Torscher Benson left the travel industry to write novels and earn her EMS degree. An EMT and Haz-Mat Operative in Wake County, NC, Dianna loves the adrenaline rush of responding to medical emergencies and helping people in need, often in their darkest time in life. Her suspense novels about characters who are ordinary people thrown into tremendous circumstances, provide readers with a similar kind of rush. Married to her best friend, Leo, she met her husband when they walked down the aisle as a bridesmaid and groomsmen at a wedding when she was eleven and he was thirteen. They live in North Carolina with their three children. Visit her website at http://www.diannatbenson.com