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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 20

Endocrine and Hematologic Emergencies

Learning objectives (16)

  1. Define the terms diabetes mellitus, hyperglyce- mia, and hypoglycemia — Knowledge/skills objective (printed page 777); confirm wording in your course copy.
  2. Demonstrate the assessment and care of a patient with hypoglycemia and a decreased level of consciousness — Knowledge/skills objective (printed page 778); confirm wording in your course copy.
  3. Describe the anatomy and physiology of the endocrine system and its main function in the body — Knowledge/skills objective (printed page 777); confirm wording in your course copy.
  4. Describe the differences and similarities between hyperglycemic and hypoglycemic diabetic emergencies, including their onset, signs and symptoms, and management considerations — Knowledge/skills objective (printed page 777); confirm wording in your course copy.
  5. Describe the interventions for providing emergency medical care to both a conscious and unconscious patient with an altered mental status and a history of diabetes who is having sy — Knowledge/skills objective (printed page 777); confirm wording in your course copy.
  6. Describe the pathophysiology, complications, and management of sickle cell disease — Knowledge/skills objective (printed page 778); confirm wording in your course copy.
  7. Describe two types of blood clotting disorders, and the risk factors, characteristics, and management of each — Knowledge/skills objective (printed page 778); confirm wording in your course copy.
  8. Discuss the composition and functions of blood — Knowledge/skills objective (printed page 778); confirm wording in your course copy.
  9. Discuss the role of glucose as a major source of energy for the body and its relationship to insulin — Knowledge/skills objective (printed page 777); confirm wording in your course copy.
  10. Discuss the steps the EMT should follow when conducting a primary and secondary assessment of a patient with an altered mental status who is suspected of having diabetes — Knowledge/skills objective (printed page 778); confirm wording in your course copy.
  11. Distinguish between the individual types of diabetes and how their onset and presentations are different — Knowledge/skills objective (printed page 777); confirm wording in your course copy.
  12. Explain some age-related considerations when managing a pediatric patient who is experiencing symptomatic hypoglycemia — Knowledge/skills objective (printed page 777); confirm wording in your course copy.
  13. Explain some age-related considerations when managing an older patient who has undiagnosed diabetes — Knowledge/skills objective (printed page 778); confirm wording in your course copy.
  14. Explain the process for assessing and managing the airway of a patient with an altered mental status, including ways to differentiate a hyperglycemic patient from a hypoglycemic pa — Knowledge/skills objective (printed page 777); confirm wording in your course copy.
  15. Explain when it is appropriate to obtain medical direction when providing emergency medical care to a patient with diabetes — Knowledge/skills objective (printed page 778); confirm wording in your course copy.
  16. Provide the forms, dose, administration, indications, and contraindications for giving oral glucose to a patient with a decreased level of consciousness who has a history of diabet — Knowledge/skills objective (printed page 778); confirm wording in your course copy.

Vocabulary (12)

Diabetes mellitus
A group of chronic diseases marked by elevated blood glucose due to defects in insulin production, insulin action, or both.
Type 1 diabetes
An autoimmune disease in which the pancreas produces little or no insulin; managed with insulin replacement.
Type 2 diabetes
A condition of insulin resistance and progressive insulin deficiency, often associated with obesity.
Hypoglycemia
Low blood glucose, generally below 70 mg/dL, producing symptoms ranging from sweating and shakiness to altered mental status and seizures.
Hyperglycemia
Abnormally high blood glucose, often presenting with polyuria, polydipsia, and over time, dehydration.
Diabetic ketoacidosis (DKA)
A life-threatening hyperglycemic emergency, usually in type 1 diabetes, with ketone production, acidosis, and dehydration.
Kussmaul respirations
Deep, rapid, labored breathing that develops as the body tries to compensate for metabolic acidosis (e.g., DKA).
Oral glucose
A 15-gram dose of glucose paste or gel placed in the cheek of a conscious patient with a gag reflex who has symptomatic hypoglycemia.
Glucometer
A handheld device that measures capillary blood glucose from a fingerstick sample.
Sickle cell crisis
An acute painful episode in sickle cell disease caused by sickled red blood cells obstructing small blood vessels.
Anticoagulant
Medication that slows blood clotting (e.g., warfarin, apixaban, rivaroxaban); increases bleeding risk after trauma.
Hemophilia
An inherited bleeding disorder caused by deficiency of clotting factor VIII or IX, leading to prolonged bleeding after injury.

Sequence practice (2 puzzles on Quiz Me)

Field treatment of symptomatic hypoglycemia

Order EMT steps for a conscious patient with suspected hypoglycemia.

  1. Confirm scene safety and airway
  2. Obtain glucometer reading if scope permits
  3. Confirm intact gag reflex and ability to swallow
  4. Administer one 15-gram dose of oral glucose
  5. Reassess in 15 minutes; repeat if still symptomatic and able to swallow
  6. Call ALS / transport if not improving or airway is unsafe
Diabetic ketoacidosis (DKA) recognition

Order the typical presentation pattern of DKA from earliest to most severe.

  1. Polyuria and polydipsia over hours to days
  2. Nausea, vomiting, abdominal pain
  3. Kussmaul (deep, rapid) respirations
  4. Fruity (acetone) breath
  5. Altered mental status / coma

Quick fire sample (12 of 12 on Quiz Me)

A group of chronic diseases marked by elevated blood glucose due to defects in insulin production, insulin action, or both.
  1. Diabetes mellitus
  2. Kussmaul respirations
  3. Type 2 diabetes
  4. Sickle cell crisis
An autoimmune disease in which the pancreas produces little or no insulin; managed with insulin replacement.
  1. Anticoagulant
  2. Type 1 diabetes
  3. Kussmaul respirations
  4. Diabetic ketoacidosis (DKA)
A condition of insulin resistance and progressive insulin deficiency, often associated with obesity.
  1. Glucometer
  2. Oral glucose
  3. Diabetes mellitus
  4. Type 2 diabetes
Low blood glucose, generally below 70 mg/dL, producing symptoms ranging from sweating and shakiness to altered mental status and seizures.
  1. Hyperglycemia
  2. Hypoglycemia
  3. Anticoagulant
  4. Diabetic ketoacidosis (DKA)
Abnormally high blood glucose, often presenting with polyuria, polydipsia, and over time, dehydration.
  1. Type 2 diabetes
  2. Hypoglycemia
  3. Hyperglycemia
  4. Diabetes mellitus
A life-threatening hyperglycemic emergency, usually in type 1 diabetes, with ketone production, acidosis, and dehydration.
  1. Glucometer
  2. Diabetes mellitus
  3. Sickle cell crisis
  4. Diabetic ketoacidosis (DKA)
Deep, rapid, labored breathing that develops as the body tries to compensate for metabolic acidosis (e.g., DKA).
  1. Kussmaul respirations
  2. Hyperglycemia
  3. Anticoagulant
  4. Type 1 diabetes
A 15-gram dose of glucose paste or gel placed in the cheek of a conscious patient with a gag reflex who has symptomatic hypoglycemia.
  1. Sickle cell crisis
  2. Type 1 diabetes
  3. Oral glucose
  4. Hypoglycemia
A handheld device that measures capillary blood glucose from a fingerstick sample.
  1. Kussmaul respirations
  2. Hypoglycemia
  3. Glucometer
  4. Anticoagulant
An acute painful episode in sickle cell disease caused by sickled red blood cells obstructing small blood vessels.
  1. Hemophilia
  2. Sickle cell crisis
  3. Hypoglycemia
  4. Anticoagulant
Medication that slows blood clotting (e.g., warfarin, apixaban, rivaroxaban); increases bleeding risk after trauma.
  1. Diabetic ketoacidosis (DKA)
  2. Anticoagulant
  3. Hemophilia
  4. Sickle cell crisis
An inherited bleeding disorder caused by deficiency of clotting factor VIII or IX, leading to prolonged bleeding after injury.
  1. Hemophilia
  2. Anticoagulant
  3. Oral glucose
  4. Sickle cell crisis

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/20/print/. Answers are not marked on this sheet.