This lecture is about Vital Signs Survey Blood Sugars and forms part of the blended learning materials available to all enrolled students of the Australian Paramedical College.
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In today’s micro lecture, we’re going to talk about the use of blood glucometry, and we’re going to specifically talk about when and where and how to do this. Now let’s think about the patient’s situation. When you arrive on scene as the paramedic, you need to try and identify why you’re being called in the first place.
So that involves doing a scene survey, looking at the global picture of what you’re faced with. As well as trying to undertake a primary survey, a secondary survey, and having to prioritize all the different types of assessments that you’re gonna do. Which will then lead you to a decision on what you’re actually physically going to do.
Now when it comes to undertaking blood glucometry you probably already read that a normal blood sugar from a pre-hospital perspective should always be above 4. Now some texts will also say that it should be below 8 or below 10 as well, but pre-hospital we tend focus mainly on the low number.
The reason being is because a patient will go into irreversible brain damage and death much quicker when their blood sugars are low than when they’re high. Plus the reality is pre hospital we cannot do a massive amount for a hyperglycemia, hyper meaning high, glycemia meaning sugar.
So with hypoglycemia we treat them with, if they can swallow we treat them with oral glucose, or we can make them some kind of sustainable sandwich. Although you get the choice of whether you’re gonna give them something that’s slow release sugar versus the acute sugar intake.
The hypo stuff that paramedics use is really highly concentrated sugar. Yes it goes into the body much quicker, you take it in, you swallow it, and it goes into the system, and it makes your sugar spike. Your body also destroys it much quicker too, so you got a bit of a decision to make on whether or not you’re gonna take the hypo or you’re gonna make them more sustainable.
You can actually give them both if you wanted to, if you know that the body destroys the sugar much quicker you can actually make them a sandwich afterwards.
The patient cannot swallow, and you’re looking at giving them a intramuscular injection of glucagon, and ideally you want to be giving them IV glucose which is the gold standard. Then of course you gotta put in a peripheral cannula which is something you’re taught in workshop 2.
Now blood glucometry is really useful, once you’ve arrive at on scene you do your primary survey, danger response, airway, breathing, circulation, hypoglycemia can present in so many different ways and if your patient is conscious and talking.
But going on that slippery slope downwards, you’re gonna struggle to be able to take a blood sugar level because they’re mostly physically and verbally aggressive. That’s a really hard thing and try to obtain, communication skills are really, really important.
For yourself and your crew mates, work systematically and carefully and professionally to get that sugar and when you see that the blood sugar levels are low, then you can treat them, but not until you’ve got that reading. If your patient is unconscious, maybe they’re having a convulsion and treat the unconsciousness and the convulsion first.
This includes using the oropharyngeal airway if they’re having a convulsion it’s the nasal pharyngeal tube, or nasal pharyngeal airway. Preventing them from injuring themselves and treating them with either the glucagon or the IV glucose.
So that’s really a micro lecture on treating hypoglycemia and using the blood glucometry.
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