first aid treatment for a hyper

[Moosepig]

at the weekend I attended a refresher first aid course for the organisation I work with. When they covered diabetes and the treatment of someone going into a collapse they said that for both a hypo and a hyper, the patient should be given a glass of warm sugary water. I queried the safety of this as I agree with it for a hypo, but surely for a hyper it will make the situation worse and increase an already elevated glucose level. Am I right? I'd value comments please as I have suggested the course needs changing.

 

[catapillar]

Is this in a context where you know the patients blood sugar level because you, as the first aider have tested them?

Because I can see why, if they are not sure whether you are low or high, it makes sense to treat it as if it's a hypo & then correct later if you were wrong. If you are hyper, but walking talking and able to swallow, going a bit higher from a bit of sugar while medical assistance is the next step isn't going to make an awful lot of difference & can be corrected later. Whereas if you are low then quick sugar intake can be minutes away from you passing out.

But if you know they are hyper, then sugar is literally the opposite of what they need. But isn't going to cause any imminent damage within, say 15 minutes, if the next step is see a doctor.

 

[urbanracer]

Well in a hyper situation, I would prefer insulin to sugary water.

Seriously, this seems like potentialy dangerous advice that your organisation is handing out.

 

[azure]

I wouldn't want anyone giving me insulin unless they were a medical professional and knew what they were doing!

Can you give us more details @mandy_horsley ? I remember being told years ago at school (basic first aid) to assume someone with diabetes needed sugar as being hypo was potentially more immediately dangerous than being hyper.

 

[Moosepig]

thanks for your thoughts - I guess the treatment covers both scenarios, but to my mind it seems dangerous increasing an already elevated blood glucose level. I think the assumption was that the patient was conscious enough to be able to drink the liquid, so presumably would also be able to say whether they had eaten or medicated recently? I'm type 2 so I'm not so conversant on using insulin as a type 1 but I know if I was having a hyper i certainly wouldn't want any more sugar in me!

 

[Moosepig]

Well in a hyper situation, I would prefer insulin to sugary water.

Seriously, this seems like potentialy dangerous advice that your organisation is handing out.

the instructor said that as a first aider we would not be allowed to administer insulin ourselves, but could assist the patient in getting it out of their pack - they would have to self medicate though.

 

[Moosepig]

I wouldn't want anyone giving me insulin unless they were a medical professional and knew what they were doing!

Can you give us more details @mandy_horsley ? I remember being told years ago at school (basic first aid) to assume someone with diabetes needed sugar as being hypo was potentially more immediately dangerous than being hyper.

the instructor stated that the first aider would not administer the insulin, drink was ok, but not insulin and being first aid - meant that the patient would be receiving paramedic/hospital support as soon as an ambulance arrived.

 

[azure]

the instructor stated that the first aider would not administer the insulin, drink was ok, but not insulin and being first aid - meant that the patient would be receiving paramedic/hospital support as soon as an ambulance arrived.

I was more responding to Urban Racer : ) And I'm pleased they said not to give insulin. It's a nightmare of mine - some 'helpful' member of the public injecting me with insulin when I'm having a hypo.

I checked the St Johns Ambulance site because that's who did my course at school, and they say it's best to give sugar if you're not sure if the person is hyper or hypo. As you say, most hyper people will be able to explain fine and answer questions, so anyone who can't but is still conscious is more likely to be hypo anyway.

 

[Moosepig]

I was more responding to Urban Racer : ) And I'm pleased they said not to give insulin. It's a nightmare of mine - some 'helpful' member of the public injecting me with insulin when I'm having a hypo.

I checked the St Johns Ambulance site because that's who did my course at school, and they say it's best to give sugar if you're not sure if the person is hyper or hypo. As you say, most hyper people will be able to explain fine and answer questions, so anyone who can't but is still conscious is more likely to be hypo anyway.[/QUOTE

I was more responding to Urban Racer : ) And I'm pleased they said not to give insulin. It's a nightmare of mine - some 'helpful' member of the public injecting me with insulin when I'm having a hypo.

I checked the St Johns Ambulance site because that's who did my course at school, and they say it's best to give sugar if you're not sure if the person is hyper or hypo. As you say, most hyper people will be able to explain fine and answer questions, so anyone who can't but is still conscious is more likely to be hypo anyway.

it was a tailored St john's course that I was attending but it is delivered to adults and young people over the age of 12 in a supervised training environment as well. That is why i queried the treatment for hypers and the trainer and I both agreed that I would put it to the forum to see how people felt about it.

 

[paulliljeros]

As stated, if someone is barely conscious, it is more likely to be a hypo. They are essentially telling you to "roll the dice" as some treatment is better than non, and you have at least 50% chance of being right, probably much greater, considering being unable to communicate from hyper is much less likely.
I always used to think this was crazy, but nowadays, taking a pragmatic look, I would rather someone take those odds than just sit back and wait.

 

[RoseofSharon]

As a first aider you are not trained to give injections of any sort, nor to take a blood sugar. Therefore treating for worst case scenario, in this case a potentially life threatenting situation in which the actual sugar level is unknown, giving a sugary drink is unlikely to do much harm unless the person has extreme diabetic ketoacidosis and could well save the persons life. For myself as a type 2 knowing the dangers of insulin incorrectly managed/administered I would rather that untrained personnel such as first adiers give me a sugary drink that doesnt work than something that could cause real problems (I personally am not on insulin atm, but dread to think what could happen).

 

[jos64]

Is this in a context where you know the patients blood sugar level because you, as the first aider have tested them?

Because I can see why, if they are not sure whether you are low or high, it makes sense to treat it as if it's a hypo & then correct later if you were wrong. If you are hyper, but walking talking and able to swallow, going a bit higher from a bit of sugar while medical assistance is the next step isn't going to make an awful lot of difference & can be corrected later. Whereas if you are low then quick sugar intake can be minutes away from you passing out.

But if you know they are hyper, then sugar is literally the opposite of what they need. But isn't going to cause any imminent damage within, say 15 minutes, if the next step is see a doctor.

That has been the first aid training I have received over the years. Now being diagnosed as diabetic I will be more aware of the potential issue

 

[KK123]

Well in a hyper situation, I would prefer insulin to sugary water.

Seriously, this seems like potentialy dangerous advice that your organisation is handing out.

This is what they teach on first aid courses. If you are hyper then a cup of sugared water or whatever would make no difference whatsoever. It would help you if you were hypo though. A person who is hyper could obviously have glucose levels off the scale and if they did this WOULD be a serious issue, however adding a bit more makes minimal if no difference and its effects would not be imminent as they are with hypos. This advice is clearly intended for a first response first aider so if the person did not revive after the sugary drink you might suspect hyper and call an ambulance anyway. This organisation is correct, you cannot expect a first aider (as in a member of the public) to start dishing out insulin, that WOULD be serious.

 

[ringi]

giving a sugary drink is unlikely to do much harm unless the person has extreme diabetic ketoacidosis

Remember that diabetic ketoacidosis is due to low insulin, not high BG, therefore giving sugar would not make diabetic ketoacidosis any worse. There has been one near death in a hospital recently as the hospital staff trusted the BG reading the paramedic got, but the lab results come back at under 2! It is thought there was sugar on the person's finger, therefore even if you have access to a meter, it may be best not to trust it when doing first aid.....

(If a person is able to test their own BG, it is not first aid. Likewise, if a disabled person you knows gives you clear instructions in what to do, just because they can't hold a meter themselves, does not make it first aid.)

 

[yakudueye1]

at the weekend I attended a refresher first aid course for the organisation I work with. When they covered diabetes and the treatment of someone going into a collapse they said that for both a hypo and a hyper, the patient should be given a glass of warm sugary water. I queried the safety of this as I agree with it for a hypo, but surely for a hyper it will make the situation worse and increase an already elevated glucose level. Am I right? I'd value comments please as I have suggested the course needs changing.

**** define rly as I drink a lot of fresh water and take insulin and keep checking its working but into hours if it didn't I go to A&e or calll the out of hours for further advise

 

[Deleted member 308541]

This in the Red Cross First Aid app for hypers.

I will have a look in my St John first aid book to see what they say if I can find it out at the shed

 

[Circuspony]

My OH asked when I was diagnosed what he should do for hypo / hyper and the advice on the Red Cross site is what we were told. Get the sugars in - you can correct later if they are too high, but its life saving if they are too low. So don't faff around basically!

 

[phdiabetic]

Thanks for checking on the correct procedure, it is very important and many people don't understand it.

Do NOT give insulin to an unconscious diabetic, they are most likely passed out due to low blood sugar. People don't suddenly pass out from high blood sugar as it takes many hours/days to get to that point, and during that time they should be able to try to fix it or seek medical assistance. Low blood sugar can happen very quickly and people may not realise it is happening, or have time to treat it. Insulin makes low blood sugar worse.

I'm not sure the actions advised in your first aid course are correct either - if somebody is unconscious or unable to eat on their own, do NOT put anything into their mouth as they may choke on it. You could rub very small amounts of sugar onto their gums, or alternatively use one of the hypo gel products. If you have access to it, you could give a glucagon injection. Whatever else you do, call an ambulance. If the person is having a seizure don't try to hold their head or tongue. If they are at risk of hitting their head on something, just move the object away and leave the person there.

 

[Deleted member 308541]

I have jut been out to the shed, and found my old 1980's edition of the St John Ambulance first aid book.

Here's their take on it.