West Coast EMT Block Exam #3 | Updated |
• hyperglycemic crisis -✓✓Pathophysiology - A.k.a. Symptomatic hyperglycemia. Occurs
when blood glucose levels are very high. The patient is in a state of altered mental
status resulting from several combined problems. In type 1 diabetes, hyperglycemia
leads to ketoacidosis with dehydration from excessive urination. In type 2 diabetes,
hyperglycemia leads to a nonketotic hyperosmolar state of dehydration due to the
discharge of fluids from all of the body systems and eventually the kidneys, leading to a
much more ominous situation of fluid imbalance.
Risk Factors -
Metabolic condition - developed origin
Chronic high glucose levels in blood
Ketoacidosis and dehydration from excessive urination for type 1 diabetes patients
Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) for type 2 diabetes patients
Hyperglycemia
Altered mental status, drowsiness, lethargy
Severe dehydration, thirst, dark urine
Visual or sensory deficits
Partial paralysis or muscle weakness
Seizures
Signs and Symptoms -
Wounds that don't heal
Numbness in hands and feet
Blindness
Renal failure
Gastric motility problems
Warm and dry skin
Rapid and deep (Kussmaul) respirations
Sweet, fruity odor of breath
• Hypoglycemia -✓✓Pathophysiology - An abnormally low blood glucose level.
Risk Factors -
Acute condition - rapidly developed origin
Weakness on one side of body (may mimic stroke)
Brain damage
Altered mental status/Rapid changes in mental status
Seizures
Rapid and weak pulse
Normal to low blood pressure
Signs and Symptoms -
Pale, cool, and moist skin
Shallow or ineffective breathing
Irritability, confusion, seizure, or coma
Unsteady gait
Diaphoresis (sweating)
, Dizziness, headache
Anxious or combative behavior
EMT Field Treatment -
Oral glucose or glucose tablets carried in EMS units
Intravenous glucose (dextrose)
Glucose gels to be spread on mucus membranes between the cheek and gum
• diabetic ketoacidosis -✓✓Pathophysiology - Diabetic Ketoacidosis (DKA) is an
emergency condition in which extremely high blood glucose levels, along with a severe
lack of insulin, result in the breakdown of body fat for energy and an accumulation of
ketones in the blood and urine.
Risk Factors -
Type 1 & 2 Diabetes with Physical Trauma or Surgery
Missing the doses of insulin injections frequently
Pneumonia and Urinary Tract Infections
Pancreatitis
Sudden Heart Attack
Skipping of Meals
Signs & Symptoms -
Abdominal Pain
Body Aches
Nausea
Vomiting
Altered Mental Status
Loss of Consciousness
Field Treatment -
Apply Oxygen as needed
Fluid Therapy
Electrolyte Therapy Intravenously
Insulin administration Intravenously
• ecoptic pregnancy (abruptio placentae) -✓✓Pathophysiology - A fertilized embryo
implanting at a site in the body other than in the uterus, 98% are fallopian tubes, with
rarer occurrences of ovarian, cervical and peritoneal implantations taking place.
Risk Factors -
Previous ectopic pregnancy
Surgery to fallopian tube
Previous sterilization procedures
Previous PID, with minor risk factors being IVF pregnancies
Vaginal douching and smoking in the periconceptual period
Signs & Symptoms -
Abdominal pain
Vaginal bleeding (presence of conception or clots in bleeding plus volume can give
some degree of severity)
May present collapsed and in shock
Peritonism or an acute abdomen
• hyperglycemic crisis -✓✓Pathophysiology - A.k.a. Symptomatic hyperglycemia. Occurs
when blood glucose levels are very high. The patient is in a state of altered mental
status resulting from several combined problems. In type 1 diabetes, hyperglycemia
leads to ketoacidosis with dehydration from excessive urination. In type 2 diabetes,
hyperglycemia leads to a nonketotic hyperosmolar state of dehydration due to the
discharge of fluids from all of the body systems and eventually the kidneys, leading to a
much more ominous situation of fluid imbalance.
Risk Factors -
Metabolic condition - developed origin
Chronic high glucose levels in blood
Ketoacidosis and dehydration from excessive urination for type 1 diabetes patients
Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) for type 2 diabetes patients
Hyperglycemia
Altered mental status, drowsiness, lethargy
Severe dehydration, thirst, dark urine
Visual or sensory deficits
Partial paralysis or muscle weakness
Seizures
Signs and Symptoms -
Wounds that don't heal
Numbness in hands and feet
Blindness
Renal failure
Gastric motility problems
Warm and dry skin
Rapid and deep (Kussmaul) respirations
Sweet, fruity odor of breath
• Hypoglycemia -✓✓Pathophysiology - An abnormally low blood glucose level.
Risk Factors -
Acute condition - rapidly developed origin
Weakness on one side of body (may mimic stroke)
Brain damage
Altered mental status/Rapid changes in mental status
Seizures
Rapid and weak pulse
Normal to low blood pressure
Signs and Symptoms -
Pale, cool, and moist skin
Shallow or ineffective breathing
Irritability, confusion, seizure, or coma
Unsteady gait
Diaphoresis (sweating)
, Dizziness, headache
Anxious or combative behavior
EMT Field Treatment -
Oral glucose or glucose tablets carried in EMS units
Intravenous glucose (dextrose)
Glucose gels to be spread on mucus membranes between the cheek and gum
• diabetic ketoacidosis -✓✓Pathophysiology - Diabetic Ketoacidosis (DKA) is an
emergency condition in which extremely high blood glucose levels, along with a severe
lack of insulin, result in the breakdown of body fat for energy and an accumulation of
ketones in the blood and urine.
Risk Factors -
Type 1 & 2 Diabetes with Physical Trauma or Surgery
Missing the doses of insulin injections frequently
Pneumonia and Urinary Tract Infections
Pancreatitis
Sudden Heart Attack
Skipping of Meals
Signs & Symptoms -
Abdominal Pain
Body Aches
Nausea
Vomiting
Altered Mental Status
Loss of Consciousness
Field Treatment -
Apply Oxygen as needed
Fluid Therapy
Electrolyte Therapy Intravenously
Insulin administration Intravenously
• ecoptic pregnancy (abruptio placentae) -✓✓Pathophysiology - A fertilized embryo
implanting at a site in the body other than in the uterus, 98% are fallopian tubes, with
rarer occurrences of ovarian, cervical and peritoneal implantations taking place.
Risk Factors -
Previous ectopic pregnancy
Surgery to fallopian tube
Previous sterilization procedures
Previous PID, with minor risk factors being IVF pregnancies
Vaginal douching and smoking in the periconceptual period
Signs & Symptoms -
Abdominal pain
Vaginal bleeding (presence of conception or clots in bleeding plus volume can give
some degree of severity)
May present collapsed and in shock
Peritonism or an acute abdomen
