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Re: [IP] EMT Training for diabetics

Mike, I would like to respond to your message.  First, you didn't state
whether you were taught at a state level test or the National Registry of
EMT's.  While States vary from State to State the National Exam is basically
a compilation of what is taught for all States.

I admire you for obtaining your EMT-B and hope you will go on in your
medical education.  Good to have you with us in EMS.

You have to remember that those of us on the Insulin Pump are unfortunately
only about 1-2 % of total diabetics.  Most diabetics either take oral
medications or Injectable insulin.  At this stage most diabetics either use
Humulin R, Humulin N, or 70/30 mix.  Also unfortunately most diabetics as
rated by professional educators are only about 50% compliant with their
medications.  Therefore, the proper questions are "did you take your
medicine today"?  To which most diabetics not on a pump would probably
respond yes (even if they hadn't taken their medication)!  Also the question
of "Have you eaten today" again 99% of the time would be yes (again even if
the answer is no)!  After 36 years as a nurse I will tell you these patients
will tell you what they know they should be telling you even if the answer
is wrong just so they don't hear THE LECTURE.

You see them in the field and I as the nurse take care of them in the ER and
they will still tell you opposites even up until proven wrong by lab
testing, and medication administration in the ER.  Next, most diabetics do
not learn carb counting without use of the pump.  Many more diabetics are
given a single or double dose of insulin to take morning and/or evening and
many never check their glucose readings at all.

You are not the responsible person for a diabetic.  Your EMT experience is
to get them to a higher level of care whether it is to an ACLS unit, or a
hospital.  All of us working in the medical field must have a team approach.
Nurses work with EMT's and Paramedics, EMT-I's and Physicians but we are all
still a team.  We should never forget we are not judgmental but we do care
for a person and their life.  Giving a conscious diabetic something to eat
or drink will never kill them but failing to act when their glucose is low
may make their injuries worse.

As you progress up the levels of EMT you will find that the treatment of an
unconscious person will be the administration of IV fluids, Oxygen, glucose,
and a narcotic antagonist.  This is because unconsciousness can be caused by
Diabetes, Alcohol, Drug Overdose, or Cardiac problems.  We treat them all
and have to follow the routine to keep people alive.  Again, being
non-judgmental in our approach.

It is true that diabetics have many more health problems than the normal
adult.  Diabetics are more prone to high blood pressure, heart attacks,
strokes, and kidney problems.  That is a well established medical fact.
Also that diabetic children will have more problems than adult diabetics.
Another proven medical fact.  Just remember all your training and why you
went through the hours to become an EMT-B.

Once again congratulations and please don't feel I am lecturing.  I love my
job in the Emergency Medicine field and hope you will enjoy your experiences
as well


Gayle Armstrong RN, CEN, Trauma Nurse Specialist
Diabetic Educator
Certified Pump Trainer
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