Endocrine Diabetic Emergencies

Patient Assessment

***As always, every assessment begins with Scene survey/safety, BSI, number of patients, resources needed, and general impression.  If the patient is unresponsive, revert to the ABC's, AHA guidelines, and your local protocols.*** 

For the AWAKE patient with a diabetic complaint, the next step is to obtain vital signs and assess the patient's mental status.  This helps determine potential treatment options.  For example, an awake patient who is confused, with slurred speech, sluggish pupils, and a low blood sugar is not an ideal candidate for oral glucose secondary to risk of aspiration, and will need ALS intervention.  

An awake patient who has normal speech, but is feeling tremulous due to hypoglycemia is likely a good candidate for oral glucose therapy.  

***Side Note***

Remember not to tunnel vision onto the glucose level in the patient with an altered mental status.  The Pneumonic AEIOU-TIPS is helpful to remember other common etiologies of mental status change.  It is especially helpful in the patient who has a relatively normal blood sugar or whose mental status does not improve after correcting the blood sugar.