Never ceases to amaze me.
"I've got the line in," announced the paramedic. Thank Gawd. He'd missed the first time. Understandable, really, what with the way Charley was flailing around on the water bed. I struggled to wrestle him into stillness. It was difficult to get a grip on him. As hypoglycemic as he was, his metabolism was in free-fall, and he was sweating buckets. Damned too if he wasn't strong, as he struggled while out of his mind. Charley's lips bubbled foamed saliva, and his eyes rolled in their sockets. The paramedic had just found Charley's blood sugar to be 28.
"I'm just so scared," his new wife said. "I've never seen him like this."
"Well prepare to see Charley come back to his senses," I said, watching the para medic screw in the huge syringe of dextrose to the I.V. line. Once he had it squirted in, he nodded smartly to his helper, who was holding the bag of saline. His helper opened up the drip. "This will be like a magic potion."
I was holding Charley's arms down, so I couldn't watch my watch to time the reaction, but I would put it at 30 to 45 seconds before he was fully aware. Fortunately, he bypassed that period that so many go through, where they wake up confused and swinging.
In four minutes, his sugar was over 200.
Charley's wife didn't know what to do, but she called 911. That ended up being enough. But why hadn't he ever discussed exigency plans with her?* Why didn't she know his baseline blood sugar level? Why wasn't there a log of his blood sugar? Why did she have to look for his medicines?
Being prepared is more than just having a loaded gun where you can reach it when the baddies come along. A frank discussion with your loved ones can save their lives.
It's still fun to watch 'em come back.
_________________________________
*She told me that she had been about to try to give him orange juice. He was completely unconscious. For the record, friends, don't pour liquids into unconscious persons' mouths. Aspirated sticky stuff in the lungs just creates a much bigger complication.
Labels: day at the office, public service message
posted by Matt G @ 3:57 AM
9 Comments:
Oh... sounds like they need to TALK... Nice save Matt!
Tubes of gel frosting are good to keep around for such events until the glucagon can be found or help arrives- rub on the gums.
And, yes. Denial Does Not Work with Type I.
Gel frosting's a good idea. I always liked sublingual use of togo packets of honey or jelly. But again, one has to be careful that it not be inhaled, as this creates more problems than just waiting for the medics to arrive with the dextrose.
Wow, I got a reading in the low 40s once. Sweating, shaking, and with an unprecedented thirst for a pint of maple syrup.
I've become a total nazi about my injectables, and my diet.
You see I want to live to see my son graduate college.
Maybe recover from my current grief, and father more children.
If you must, rectal administration of oral glucose gel or honey works.
Don't ask me how I know. It was an ugly call.
Wow, A.D.
Just...
Wow.
A.D.: Did you actually find that in some obscure manual, or just make it up on the spur of the moment when you recognized the pt?
For that matter, did you at least remember to open the quart bottle first? :)
KD5NRH,
It was fifteen years ago, with every available vein blown, no Glucagon available, and before IO access became commonplace.
I was 45 minutes from a hospital, and figured, "What the heck, it is a mucous membrane, and there's no way she can aspirate it..."
It worked, too. Brought her sugar from less than 40 to 76 by the time we got her to the hospital.
I knew about rectal administration for glucose, and for re-hydration purposes.
But, I echo your comment Matt!
Just Wow!
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