Diabetic Emergencies, What YOU Can Do

[@Minuteman4Jesus]

When I was part of the Indiana Militia back in the 1990's, guys thought I was crazy training with a full loadout until our BCT leader (a type 1 diabetic) started 'crashing'. I had 3 days' ration in my patrol pack and gave him some koolaid, a brownie, and cheese tortellini. He swore I literally saved his life and I played it down, just saying I was helping a team-mate. As the years have worn on, I've thought about this and realize that even with an emergency extraction from our location, he wouldn't have made it to the hospital. This only reinforced what I learned in Boy Scouts: ALWAYS BE PREPARED.

[@dannyappleby703]

The worst fight I’ve been in as a police officer was 14yo girl who tried to kill her mother. A close second was a hypoglycemic diabetic who was trying to fight anyone he could. We recognize it was a medical emergency and were trying to use as little force as possible. Took two cops and three firefighters to get him under control so the paramedics could work on him. I was dispatched to call him the next shift. He was very apologetic and appreciative of everything we did for him. I ended up with a black eye, split lip, and nice bite mark on my forearm.

[@JosephApuzzo-j6p]

I've been a type one diabetic since 1978 And I've also been a paramedic since 1982. You did an excellent job with that talk just enough. Very well done. Oh, one more thing. Please tell people that if you're going to wake up an unconscious diabetic and you rouse them and you. try to give them sugar. PO, don't give them 90,000 grams of sugar. It's just not necessary. And you're going to drive them into a bad osmotic state later. Just give them what you need to wake them up. I can't tell you how many times I've seen less educated people forcing diabetics to keep eating and keep eating and keep eating sugar and orange juice when it's. then clearly on the way back to axox3 and they're just force feeding them. Well, I keep thinking of things. The other thing to throw in there is that, when in doubt, no matter what it is that's going on, just a reasonable amount of sugar and see what happens if they're high, it's not going to drive it that much higher. And if they're low, you're probably going to see a good result.

[@Zaephrax]

Some extra points for the use of the glucometer: The finger pad should be avoided as it can cause sensory damage through scarring if you pierce it (peripheral neuropathy), which is why it is correct to use the side of the finger. Its generally advised to avoid the thumb and index finger as these are the ones that are used most often (and its more for patient comfort than anything else). "Milking" the finger from the base to the wound is good, but avoid squeezing the tissue surrounding the wound too much as this can cause more serous fluid to come out and effect the reading. The end of the testing strip is a capillary (not a tray) so you want to introduce the blood to the end of it and let it suck the blood up rather than placing the blood on top (I usually see this mistake happening with testing solutions for calibration)

[@kennysboat4432]

This is a helpful comment. As an emt who does glucometry everyday I didn't actually know all of that.

[@MrSumGuns]

As a retired firefighter/medic 30 years on the job this has to be the best explanation/ training video I have ever seen for the layman. I also happen to be be type 1 diabetic myself. I have saved this so I can share with my family and friends. Great job great video!

[@MGoat76]

Agreed. So good!

[@DiamorphineDeath]

How did you work that with your department?

[@davidbruner9263]

I volunteer at a local fire department and also volunteer at my regular job on our emergency response team. Your videos have helped me a lot over the last few years. Thanks and keep up the good work.

[@greymanairsoft2623]

Really enjoyed you covering medical issues. Love the content but it's nice to see something more than trauma

[@PrepMedic]

It’s from the glucose molecules increasing the osmolarity of blood and pulling fluid from the interstitial space

[@superhorse3217]

I am a type 1 diabetic. Great video explaining what someone can do when things go wrong. Ive been prescribed these glucagon injections before, but recently Ive been prescribed a glucagon nosespray. This is so much easier for other people to administer. I always carry it with me in my bag and tell the people I'm with where it is and when to use it.

[@elizabethwillars838]

Friends and family of diabetics, watch this then watch it again. Be prepared, call EMS because that’s what they’re here for. It’s a little scary but just educate yourself and call when you need help. This morning my type 1 partner was low, altered and swinging at me. I couldn’t get him to let me test BGL, he refused to drink or eat glucose. And that dummy hasn’t refilled his glucagon since the last time I had to use it. So frustrating. Lowest ever recorded when we checked him was 12. Yes TWELVE (not today). I do understand my scope of practice (I’m an EMT-B), and yes I called paramedics that time.

[@TheRealRomansThirteen]

My ma used orange juice in a gas station and saved a mans life.

[@rsurdyk]

That's an old og method. Oj and peanut butter. Carbs bring your sugars up. Peanut butter is protein and it will help hold you up

[@DiamorphineDeath]

Depends on the amount of insulin administered and how deep you are in the hole. The classic one cup of oj and peanut butter and crackers won’t do much if a child accidentally gets dosed with say 30 units of humalog by mistake when the parent meant to administer the 30 of Lantus. Which happens quite a bit. Always try and relay that to people, not all hypoglycemia’s are built the same, some are weaponized and extremely serious and the response is pretty intense.

[@rsurdyk]

@DiamorphineDeath iveI'been deep in the hole.. tanking out. Because of that exact reason. As a t1d i NEVER go anywwithout my kit. Honey is the absolute best and fastest its a mono sacheride. Its already been difested so that process is not needed. It never goes bad. I keep a half cup in a squeeze tube.. and I make jerjy so I've always got some on me. But never go unprepared as a diabetic. I have an injection kit but that takes so long.

[@DiamorphineDeath]

@@rsurdyk I do the same thing with a bottle of honey in the glove box when I work on the ambulance; did the same on a fire crew on wilderness fires. Honey is the GOAT dude

[@rsurdyk]

@DiamorphineDeath like I tell my friends.. if you see me walking up the road. Fs43.. logging road..with a few quarts of honey. Mind your own. Death by honey. Lol bahahahaha I live mountainous. Neighbors are bee keepers. Free honey

[@matztertaler2777]

I was an emergency by myself in january, could not see anymore , could not speak anymore. Drank 5 liters water every day for 2 days. Rushed into the hospital: Sugar was 680 , long time sugar in the body was 14. They told me i am a type 2 diabetic now. Now, 6 month later, i lost over 30 kilos ( was 167 kilogramm ) , long time body sugar now is 5.9. Thanks to diet and trulicity , i am on a good way back to anormal life. No more White oat wheat, no sugar, soft drinks, Frust drinks, White bread, etc. Guys, be aware what you eat, it can kill you or make ypu stay healthy. I learned it the hard way.

[@garyjones1410]

Im a EMT1 and always struggled with the insulin with this issue, thank you this is much better than my class

[@preacher1776]

A month ago, I was driving back to Austin from Houston and I'm a type 1 diabetic. It was midnight when this happened. I remember thinking things weren't right, checked my sugars, and I was below the 40mg/dL OMG threshhold was met. I remember somehow calling my wife and telling her I was going to die because nothing was open where I could get sugar. Long story, but, I pulled over, and was able to mumble, "Cladwell...hotel....dying." I think I was closer to 30mg/dL by that time. Thank God the 911 operators figured out where I was based on that mumbling. They got me in the bus, and gave me glucose. Took about 20 minutes, but I was able to drive home. Be very careful on your insulin deployment for food, and, keep some sugar with you in case of emergency. Great discussion on the topic.

[@josupermom2042]

I keep packs of jelly in my first aid kits for this reason.

[@Type_One_Diabetic]

Do you have a CGM?

[@preacher1776]

@@Type_One_Diabetic Yep. But by the time it went nuts, I was way off.

[@preacher1776]

@@josupermom2042 Me too. But, where I was when this happened, I couldn't remember where the sugar was. When I looked in my normal spot, and the glucose wasn't there, I had no idea where else to go. I'd totally say, make certain the "normal" reaction response, make sure sugar is there. Also, write on your drivers license "T1 DIABETIC". It'll help in an emergency when you can't respond.

[@Type_One_Diabetic]

@@preacher1776 At least your still here now, stay safe man. 😀👍🏼

[@VDVit_2013]

Thank you so much Sam. Great supplement to basic first aid training. Definitely keeping the "1 looks like a needle" for remembering types.

[@jammer2isme]

GREAT video! I'm a type 2 like my dad was and learned all the fun stuff to do in his case..and later mine. He got lucky when passed out driving and state trooper in Florida didn't try to arrest but instead recognized signs and got glucose into him. I've had both stupidly high (1576!) and low blood sugar incidents and both times was very lucky that someone knew what to do. I now keep fast carbs and a glucometer in my work bag and try to stay on top of things as much as possible.

[@webfreezy]

There's something wrong: 1:26 you say that Diabetes is the pancreases inability to produce insulin. While that's true for type 1 diabetics, it is not necessarily true for type two diabetics, especially not in the first years usually as type 2 is about insulin insensitivity, not production in the first place.

[@jonathanstevey1748]

Also known as insulin resistance

[@webfreezy]

@@jonathanstevey1748 Thx

[@jonathanstevey1748]

@webfreezy no problem. It's my daily reality so that's how I knew the term.

[@webfreezy]

@@jonathanstevey1748 Also mine, because my wife has type 1

[@pinking5555]

Since I got camping a lot and can have major swings in temperature I usually carry a 3-4 pockets of sugar those hypoglycemia and pour it or have them pour it under their lip next to the gums. Hyperglycemia is a bit harder in the backcountry. All we can do is evac them out for medical attention.

[@arranbtag]

A slight difference is over in the UK we use Mmols so it’s a different measurement, milking the finger is the technical term here as per my daughters endocrinologist and with the gulcagon there is an updated system which works like an Epipen called an Ogluo pen which uses glucagon without having to mess about and is available in Europe and UK and reading about them they are looking to expand into the USA made by a company called Xeris Pharmaceutical Sam putting 1st rate info out as usual great video 🍻

[@TheRealRomansThirteen]

I've always thought about like a choking situation or a car accident, but this one is another to think about because it is common.

[@zeuss9999]

Type 1 Diabetic now for 43 years. Apple juice brings you out of a Hypo quickly. Thank you for the video!

[@danduhman1955]

T1D for 33yrs. Excellent presentation. Sharing with my wife & EMS responders at my place of work.

[@swahny802]

Type 1 diabetic right here. Love the vid

[@Doc_Egan]

Great lesson, Sam! I really do love your bite-sized medical condition and treatment videos. They are great refreshers for medical personnel like me. I imagine they would be great for students too. I like the gear videos too but I enjoy this type of video the most. Keep up the great work. I'm a big fan.

[@pnowikow]

Very helpful. Thanks. Getting a meter and strips for my father in-law to keep at my house. He's always falling asleep after a big meal

[@Qigate]

I very much enjoy and appreciate these deeper dives into EM care

[@edwardebroome8]

I appreciate the video. I’m type 1 since age 42. It’s an invisible disability. Thankfully with continuous glucose monitoring CGM, it’s helped as I can see the number and how fast I may be dropping. It’s humiliating to ask for help but I’ve had to do it.

[@Kingjohn2500]

I learn so much in these videos. Please don’t stop uploading

[@ashikupal9978]

My father has one of those to measure his blood sugar . And he taught me how to measure blood sugar

[@webfreezy]

In the EU glucagon can also be taken through the nose by inhalation (Baqsimi by Eli Lilly), seems to not be available in the US up to now, obviously.

[@mikehowell5539]

Have recently seen it here in the US in a skilled nursimg facility. Worked well. Have yet to hear it on the ambulance but can see it having a place in the toolbox

[@kathybullmer8884]

Great video!

[@Mrcampbell1986]

I’d like to see the IN glucagon available for BLS providers in the field. That way they can get something on board if ALS is not available or they don’t want to risk having the patient aspirate with the oral glucose.

[@PrepMedic]

Most states allow EMTs to do IM glucagon.

[@estonsman4566]

Can you make a video about treating snake bites/how to act in a situation like this? Btw really appreciate you educating us on such important info.

[@petermorrison9568]

Great video also Alot of Type 1 Diabetics are know using CGM A sensor thats works with either a smart phone or meter so worth checking the top part of the arms see if they have one and use that saves the blood test.Results are around 5 to 10 minutes out depend on type of sensor hope this is of some help to people may be a video of these would also help some cheers. Also jelly babies are very good if they are able to eat work well.

[@DrAlNguyen]

@PrepMedic Love your videos and I appreciate you sharing this great information. Something to add regarding the glucagon is that there are a few new formulations/administration routes available by prescription from the doctors for diabetics. There is nasal spray glucagon, Baqsimi, and pen autoinjector glucagon, Gvoke. When my patients are able to afford it, or if it is well covered by insurance, I routinely try to transition my patients from traditional bottled glucagon over to the nasal spray and autoinjectors due to ease of use and ease for family/friend/good samaritans to use. Also, as a good reminder to train family, friends, and co-workers on how to use it as they may be the only ones available to provide care when the diabetic is altered.

[@vm1776]

I'm a type 2 diabetic. Many of the glucometers will say whether it feels that the reading is low, high, or in range; many diabetics don't agree with the machine as to what is low/high/ok but if I'm unable to test myself and judge I'd want my family or friends to go by the machine's judgement. I've never been too low, but I also am not on insulin yet. I have been too high and for me a BG of over 220 can trigger a migraine, affect my vision and balance, and will affect my thought processes and ability to communicate and make decisions. I've been told by EMT's locally that they will not test blood sugar and if they see these symptoms they will assume that I"m too low and give me a candy bar and if my blood sugar is that high I probably would follow instructions and eat the candy. In the short term, I understand that they do this assuming that the diabetic is low and that if they are wrong the hospital can give insulin. But as a type 2 who's trying to keep BG from going too high with just diet and exercise, eating a candy bar sends my BG on a spike that ends up with a rollercoaster of readings for the next day or 2 which is difficult to deal with. I wish that more EMT's had the knowledge that you are giving, then I wouldn't have the fear of them taking a high blood sugar and skyrocketing it.

[@Pilgrim420]

Much appreciated, thanks Sam👊

[@emsservices6090]

In the UK ambulance services, we've been told that we are NOT to use alco wipes under any circumstances, as it messes with the readings, even when dried. We use a chlorhexidine / clinell wipe.

[@KiboNagasaki-uk1il]

Can you review MERET bags?

[@kenzierussell3241]

I’m thankful once EMT arrived on scene the recognized my high blood sugar from what I’ve heard I got several doses of narcan from the cops even with my friends telling them I was diabetic! First and only time I’ve been unconscious from high blood sugars super scary

[@alanmurdock4319]

I like to be prepared for mine or somebody else's emergency, but this is beyond what I can carry or be prepared for. Good info though.

[@DawidKellerman]

We were taught not to "milk" as it adds plasma from the tissues.. so I don't do it. Its common to use honey here I am IN Namibia similar in South Africa as far as I know

[@bobbyjones7505]

I just discovered your channel It’s awesome How can you treat a staph infection in a grid down scenario I’ve always wondered this?

[@stevenscott7915]

Very nice! Where can I get a copy of the DKA insulin chart?

[@spencermoore1749]

Yes, diabetes is pretty tough for a lot of people because I am a person living with adult juvenile type one diabetes. I’ve had all my life. I’ve had it since I was first diagnosed at the age of 11 or eight or nine or five or two years old or two years old ones were diagnosed as a juvenile diabetic, yes diabetes is pretty tough. Sometimes when you’re trying to control your blood sugar, that’s why I have the slim insulin pump the slim pump that constantly provides me with insulin and manages my blood sugar so diabetes can be tough sometimes for a lot of people.

[@jefflarson4982]

The instructions are on the kit too

[@OngoGablogian185]

Diabetic emergency? There's only one doctor I'm calling. Dr Pepper.

[@teun_funkmen665]

Haha love this one!

[@stefanoskamakian5210]

Can you recommend a company that sells medical packs and items in Europe?No US company sells to where I live😢

[@jg85rocks]

Have you checked with Refuge Medical? Not sure exactly what you’re looking for, but they do some international shipping to certain areas according to their website.

[@Surviving_with_Azreal]

3:22 I'm hypoglycemic I burn off more sugar than my body can create in hand I am not dependent upon injections but I do tend to eat sweets a little bit more to help out because I also burn a lot of calories in a day along with the sugar content Plus on top of that my body Burns off more sugar than everybody that I know I'm 39 going on 40th year and I still look like I am in my twenties legitimately

[@Type_One_Diabetic]

Yeah, I approve. 👍🏼

[@brucewarren5248]

Great video, but how do you remember all this stuff?

[@jefflarson4982]

Ive had frosting tubes squeezed into the back of my cheek when i couldnt chew and it worked

[@rsurdyk]

Im type 1D honey is a monosacharide. Already digested so your body skips that process and hits faster. Saves lives..

[@jefflarson4982]

Honey works well too so do glucagon kits

[@rowanspear1]

I'd like to have seen a mention of insulin resistance in this video.

[@Boone22]

My husband is Hypoglycemic, when he comes in white as a ghost,shaking and weak , i give real fruit juice or jelly at first,than he eats a meal..this has seem to work for him. He has a family history of juvenile diabetes (his brother was found in a coma at age 8),his other brother became diabetic at age 33. I try to keep a candy bar or juice always available for my husband also.

[@spencercolton8638]

I deal with diabetic episodes multiple times a week, plot twist I’m the type 1 diabetic

[@EMS101RRR]

love it

[@mahbuddykeith1124]

Cheyne-stokes breathing is from stroke/CHF, right?

[@PrepMedic]

Usually from increased ICP. Not really associated with CHf

[@mahbuddykeith1124]

@@PrepMedic Ah, right. That was taught in head-spinal trauma day. I got one more week to go, then a one week scope update before I can book my licensing exam.

[@MichaelTV44]

6:20 would that still be DKA or is it HHNS with a BGL that high?

[@PrepMedic]

Usually HHNS past 600

[@BillMooney-r5c]

The increased urination and intake is due to the bodies desire/need to flush excess glucose.

[@kissitnow898]

A lot of people now have the nasal powder baqsimi... much easier to use for laypeople. I am diabetic and always have it with me just in case

[@SaquonBagger]

Have you ever arrived on to a scene and pushed narcan just in case even though it ended up being hypo/hyperglycemia

[@evildaddysteve]

Think he meant Kussmaul Respirations.

[@PrepMedic]

Hence the correction on the screen.

[@rsurdyk]

Walmart you can get a meter with 25 strips and lancet for under 10$

[@matthewnewbold8691]

Not seeing a whole lot of big numbers here. I came for the “it’s over 5000!” post 😂

[@checkitoutlala]

LOVE this =)

[@nicmackowey510]

My husband was a type 1 diabetic who many times went unresponsive cause he would d.k.a and still refuse to go to hospital

[@joash480]

one quick way to know a patient is DKA is thru their breaths, it smells like acetone and you can easily smell it by them simply talking

[@DiaVlad420]

Hi, iam diabetic first type And serving on Ukraine miltary..Its hard but posible.

[@ltmongoose1594]

Apple juice works good

[@masterlegoking1]

In the fight against misinformation a few points should be re-researched and re-evaluated. Perhaps an edit should be done as well. 1st type is known as IDDM1 which is typically caused by an autoimmune disease affecting the pancreas which destroys the beta cells in the islet of langerhans in the pancreas or is genetic. This leads to little to no insulin production meaning they are often on insulin pumps or regular injections. Type one is also know as juvenile Onset diabetes and it starts in younger ages such as childhood or young adult years. Type 2 commonly referred to NIDDM is often not insulin dependant but can become so if poorly managed. Type 2 is typically managed through diet, exercise, and pills such as metformin. Type 2 is aka adult Onset diabetes cause it starts later in life with poor dietary habits. The pancreas may produce normal or even increased amounts of insulin in early Type 2 and will remain producing healthy amounts if well managed. However the pancreas can and does often have reduced insulin production in many people with / subtypes of type 2 diabetes. Type 2 most often occurs when the body's cells become resistant to the insulin due to high levels of blood sugar thus the insulin is no longer effective leading to even higher levels of blood sugar. This over time can damage the pancreas or teach it to produce less insulin due to the cells essentially saying they do not need the insulin. 2nd Kussmal breathing is a fast, deep, labored breathing associated with DKA and the polydipsia, polyphagia, and polyuria. Cheyenne-Stokes is an regularly irregular breathing pattern of fast-slow-fast-slow associated with TBI and increased ICP. Cited Sources: my.clevelandclinic.org/health/symptoms/24593-kussmaul-breathing www.ncbi.nlm.nih.gov/books/NBK448165/ www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011 www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193 I encourage and welcome additional clarification and polite / professional discussion about this comment. If you plan to counter please cite your sources so I can research the evidence of your claims. At the risk of sounding like an internet hater or troll or some angry idiot.... To @prepmedic I have to come to expect high levels of accuracy and quality in the videos you produce. I sometimes feel a certain aspect is missed or under discussed in some videos and will comment add-on as I feel necessary to help contribute. This is the first time I felt that the explanation of the Pathophysiology regardless of the audience was lacking in accurate information that could've been easily Google. I teach & tutor alot of EMT & Paramedic students so I often study and refresh myself on the material before doing so. I hope you do the same before these types of videos as alot of EMT and paramedic students watch them for study content and I often share your videos with my students due to the thoroughness and accuracy of information. I hope to continue doing that in future. Please keep the information as accurate as possible.

[@PrepMedic]

Make sure you watch the video and the corrections put on the screen in text as well as the “layman’s explanation” warning at the beginning of the video (I also talk about all the sub types of diabetes and how I’m not discussing them).

[@PrepMedic]

I agree insulin resistance should have been mentioned but ultimately it doesn’t change treatment or even evaluation for a layperson.

[@masterlegoking1]

​True enough, I understand now this was directed at lay people and I love using your content to help teach & tutor. Perhaps you can make a similar version of this video but more directed for the professionals? ​@@PrepMedic

[@rsurdyk]

Honey under the tounge has saved my life .. i hit 29.

[@hiddenrhythmsmusiccircles]

*ketoacidosis 😉

[@diabeticinthewild]

*shakes head*

[@GreenLabLawncare]

It’s keto not kito

[@flyboy8752]

I was about to comment that minor nitpick too (at 4:45 mark) but figured I’d check to see if anyone caught it, which you did.