I got there and immediately spotted him. A man about 35 years old was sitting on the floor below a teller’s window. He was pale and sweating.
“He’s been belligerent and loud,” the manager informed me. “He caused a scene and frightened everyone. He finally just fell over like that. Can you get him out of here?”
I approached the man, “Hello,” I said, “I’m Lisa. Can you tell me what’s wrong?”
“Yes,” he hissed. “I’m on the floor.” His words slurred, and he seemed confused. I could smell the odor of alcohol on his breath.
“I see you’re on the floor. Can you tell me how you got here?”
He didn’t answer.
I went to check his vitals and spotted a medical alert bracelet on his wrist. It wasn’t too much of a surprise to discover that the man was diabetic. His name was printed on the back. “Mr. Stefany,” I said. “Have you taken your insulin today?”
I knew he’d only get worse if his blood sugar was low, so I pressed. “When was the last time you ate?”
“Go away,” he growled.
I asked the manager to get some sugar packets from the coffee area. He came back with a handful and then, at my request, went to call an ambulance. I poured a small amount of sugar inside Mr. Stefany’s mouth to see how he’d react. He swallowed. I asked if he could take a little more. “Yes, more, please.” He said. He had four in all.
The sugar produced a big change. The man still seemed weak, but he was calmer, able to talk. I told him an ambulance was coming, and he agreed to go to the hospital. When the EMT’s arrived, I gave them the empty sugar packets, pointed out the man’s bracelet, and described the incident as best I could.
The manager and I talked later. “I really had the guy pegged as a drunk. How did you know he wasn’t? I told him I had taken a Health Guardian class as part of my training, and then explained medical alert tags. He said he wouldn’t jump to conclusions next time.
SIGNS ANS SYMPTONS
The signs and symptoms of hypoglycemia often mimic those of stroke or of alcohol or drug intoxication. The most common are as follows:
- Normal or shallow breathing
- Normal or rapid full pulse
- Normal or lower than normal blood pressure.
- Pale, moist skin. Profuse sweating.
- Irritability. Anxiety. Combativeness. Behavioral disturbances.
- Speech difficulties.
- Absence of thirst. Occasional hunger.
- Weakness or paralysis of one side of the body.
- Tremors. Convulsions.
- Confusion leading to disorientation and coma.
Emergency care for a suspected hypoglycemic patient is as follows:
- If the patient is conscious, give a commercially available glucose paste. You may instead give orange juice with one or two teaspoons of sugar, soft drinks that contain sugar, corn syrup, sugar cubes, honey, jelly, Life Savers, gum drops, or other candy. If nothing else is available, give simple table sugar. Also, administer high concentration oxygen, if you are properly trained and allowed to do so by local protocol.
- If the patient is unconscious, establish an airway. Administer oxygen. Assist ventilation if necessary. Monitor closely. Follow local protocol.
- Never give an unconscious person anything to eat or drink. Watch for complications, such as shock or convulsions. Care for the patient appropriately.
- Activate the EMS system immediately, even if the patient seems to be completely recovered. Improvement usually is fairly rapid after sugar has been given. Even so, transport the patient to a physician. Do not worry about the amount of sugar given to the patient. The physician will balance the need for sugar against insulin production when the patient arrives at the hospital.
It is important to note that diabetics are not the only patients who are prone to hypoglycemia. Alcoholics, some ingested-poison patients, and others may develop the same syndrome. So do not discount hypoglycemia in comatose patient just because he or she is not know to be a diabetic.