Hyperglycemia – Quick and Dirty
Root: Hyper-excessive, Glyc – sweet, Emia – blood
Hyperglycemia is high blood sugar. It takes a while to progress and is accompanied by excessive urination and thirst. Symptoms don’t usually start until over 250mg/dL, but a chronic blood glucose of 125mg/dL can damage organs over time. Insulin dependent diabetics (Type I) take insulin to help metabolize their blood glucose. When they do not take their insulin, that blood glucose builds up in the plasma. It can become a serious situation when the body has no insulin to move glucose and starts burning fat for energy, creating a waste product called ketones. They build up in the bloodstream and create an acidic blood state called ketoacidosis, which can be life threatening.
Altered mental status
Nausea and vomiting
Kussmaul respiration (Deep and Rapid)
Acetone or fruity breath odor
Questions to ask
Are you a diabetic?
Do you take insulin?
Did you have it today?
When was insulin last taken?
Example Treatment Protocol – Short:O2, IV, Monitor, Fluid bolus, Zofran
(over 300 in non-diabetic, or over 400 in diabetic patient with symptoms)
• Establish IV NS and administer 500cc bolus
• If patient is vomiting consider Zofran, 4mg IV/IM
• Administer oxygen as needed and provide cardiac monitoring
• May repeat NS 500cc bolus.
• Transport in position of comfort, to avoid further nausea, vomiting, and aspiration.