SUGAR

1. Hypoglycaemia (low blood sugar)

Introduction

When the blood-sugar level falls below normal (hypoglycaemia) brain function is affected. This problem is sometimes recognised by a rapidly deteriorating level of response.

Hypoglycaemia can occur in people with diabetes mellitus and, more rarely, appear with an epileptic seizure or after an episode of binge drinking. It can also complicate heat exhaustion or hypothermia.

Recognition features

There may be:

• A history of diabetes; the casualty may recognise the onset of a "hypo" attack.
• Weakness, faintness, or hunger.
• Palpitations and muscle tremors.
• Strange actions or behaviour; the casualty may seem confused or belligerent.
• Sweating and cold, clammy skin.
• Pulse may be rapid and strong.
• Deteriorating level of response.
• Diabetic's warning card, glucose gel, tablets, or an insulin syringe in casualty's possessions.

Treatment

Your aim is to raise the sugar content of the blood as quickly as possible and to obtain medical help if necessary.

• Help the casualty to sit or lie down.
• Give them a sugary drink, sugar lumps, chocolate or any other sweet food. Don’t give them diet drinks, they don’t have the sugar in them that they need.
• Alternatively if the patient has their own glucose gel help them to take it.

If the casualty responds quickly:

• Give them more food and drink and let them rest until they feel better.
• Advise them to see their doctor even if they feel fully recovered.

Warning! If their consciousness is impaired don’t give them anything to eat or drink as they may not be able to swallow or drink it properly.

If the condition does not improve:

• Monitor the level of response and look for any other possible causes.

If the casualty is unconscious:

• Open the airway and check breathing. (primary survey)
• Give chest compressions and rescue breaths if necessary.
• If the patient loses consciousness but is still breathing normally place them in the recovery position.
• Dial 999 or 112 for an ambulance.
• Always monitor and record the vital signs, levels of response, pulse and breathing for instance and give this information to the emergency services when they arrive.

2. Hyperglycaemia (high blood sugar)

Introduction

High blood sugar levels (hyperglycaemia) over a long period can result in unconciousness. Usually the casualty will drift into this state over a few days. Hyperglycaemia requires urgent treatment in hospital.

Recognition features

• Warm, dry skin.
• Rapid pulse and breathing.
• Fruity/sweet breath.
• Excessive thirst.
• If untreated, drowsiness, then unconsciousness.

Treatment

Your aim is to arrange urgent removal of the casualty to hospital.

• Dial 999 (or 112) for an ambulance.
• Monitor the level of response and look for any other possible causes.

If the casualty is unconscious:

• Open the airway and check breathing. (primary survey)
• Give chest compressions and rescue breaths if necessary.
• If the patient loses consciousness but is still breathing normally place them in the recovery position.
• Dial 999 or 112 for an ambulance.
• Monitor and record the levels of response, pulse and breathing.