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Nimelennar t1_jdcmpd5 wrote

Reply to comment by jackyj888 in (Biology) How far down your spine can you break before respiratory impairment? by Anomaly-Friend

>Is that still taught?

Unless things have changed in the past year or so, since I last took a course.

>Call 911 or a trusted family member/spouse of the effected person.

Yes, if someone is in obvious enough distress that you're concerned about either hyperglycemia or hypoglycemia, you're going to want to get help to them. I should have mentioned that.

>Typically a glucometer is gonna be right next to the insulin or in a diabetics medical supplies.

Sure, but as a first aider, you're not typically trained to use it. I mean, it's not rocket science, but (IANAL, just someone who has taken a lot of first aid courses) Good Samaritan laws only tend to protect you within the scope of your training, and for anything you do outside of that training (like taking even a tiny blood sample), you can be held liable for if things go wrong.

Of course, if the 911 operator instructs you to, that's fine (at that point, you're acting under their authority, rather than your own as a first aider), but it's not something I'd recommend taking initiative on.

>If they are unconscious, don't try to put food or water in their mouth.

I was taught this is the only exception to that rule; a small amount of sugary gel (e.g. honey or icing), deposited in the cheek.

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ilikeyourjacket t1_jdcp1bw wrote

Hmmm I think I would be wary putting something in the mouth of someone who is completely unconscious as they have a high risk of aspirating because they lose their protective airway reflexes.

But by all means if someone has reduced consciousness but they’re still able to swallow then we essentially use exactly that in the hospital context: a sugary gel as first line treatment of hypoglycaemia.

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Nimelennar t1_jdctp7t wrote

I think that's the rationale behind putting it in the cheek (i.e. between the teeth and the lips), and of using a gel instead of a less viscous liquid like a juice: to minimize the risk of aspirating it.

At least one first aid instructor I've had has suggested running the gel into the flesh of the lips and gums, which should reduce that risk even further, but I don't think that was ever a formal part of the training.

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jackyj888 t1_jddjksx wrote

You are correct. It is absolutely against common medical teaching and 99% of prehospital protocols to put glucose paste or anything else in the mouth of an unconcious diabetic. Altered LOC, sure, but not unconcious.

I'm sure you also know as a nurse that it would be absolutely a bad idea to start administration of sugar or insulin prior to obtaining blood glucose.

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jackyj888 t1_jddj23y wrote

>Sure, but as a first aider, you're not typically trained to use it. I mean, it's not rocket science, but (IANAL, just someone who has taken a lot of first aid courses) Good Samaritan laws only tend to protect you within the scope of your training, and for anything you do outside of that training (like taking even a tiny blood sample), you can be held liable for if things go wrong.

It's more in scope than administration of sugars or insulin to a diabetic, which is typically a medic though sometimes an EMT skill.

Ting a first aid course or being first aid certified doesn't even include a scope of practice anyways.

>Of course, if the 911 operator instructs you to, that's fine (at that point, you're acting under their authority, rather than your own as a first aider), but it's not something I'd recommend taking initiative on.

Again, you can get someone killed by administration of sugar or insulin, and administration of sugar or insulin is beyond first aiders/Emr anyways.

Unlike using insulin or sugar, using a glucometer poses 0 risk to the patient unless you somehow manage to miss the finger and poke them in the eye or something.

>I was taught this is the only exception to that rule; a small amount of sugary gel (e.g. honey or icing), deposited in the cheek.

Big no no. Absolutely do not do this and this hasn't been recommended for like over 20 years, at least in the USA. An unconcious diabetic needs a line, not stuff put in their mouth.

Source: Degree in Paramedicine, and a career working as a medic on the ambulance.

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