Chapter 13

Diabetic Emergencies and Allergic Reactions

Lesson Objectives

• Define diabetes, differentiate between type 1 and type 2 diabetics, and know how to manage diabetes in the wilderness.

• Know how to recognize and manage acute complications of diabetes, including insulin shock and ketoacidosis.

• Know how to recognize and manage allergic reactions, including anaphylactic shock, allergic rhinitis, and hives.

Diabetic Emergencies (1 of 6)

• Diabetes– Type 1 (insulin-dependent diabetes):

Body produces little or no insulin.– Type 2: Body produces some insulin,

but not enough.

Diabetic Emergencies (2 of 6)

• Diabetes– Diabetics in the wilderness:

• Diabetics should let group leader know of condition; discuss trip with physician, and carry adequate supplies.

• Supplies include medications and equipment.

• Insulin and glucagon should be protected from heat and cold.

Diabetic Emergencies (3 of 6)

• Acute complications of diabetes– Insulin shock: Body gets too much insulin, too

much exercise, or too little food, causing blood sugar level to fall too low.

– Ketoacidosis: Body has too little insulin causing blood sugar levels to become too high. Develops more slowly than insulin shock.

Diabetic Emergencies (4 of 6)

• Acute complications of diabetes– What to look for: Insulin shock

• Sudden onset of pale, cold, clammy skin and rapid pulse

• Headache, hunger, dizziness, nervousness, and weakness

• Staggering, poor coordination, and trembling

• Mood changes

• Altered mental status

Diabetic Emergencies (5 of 6)

• Acute complications of diabetes– What to look for: Ketoacidosis

• Gradual onset of flushed, dry, warm skin and rapid pulse

• Rapid, deep respirations• Extreme thirst• Fruity odor of breath• Vomiting• Frequent urination• Altered mental status

Diabetic Emergencies (6 of 6)

• Acute complications of diabetes– What to do:

• Check blood sugar. • Determine if victim has an injury or illness or both.• Conduct an initial check and care for immediate

problems.• If blood sugar is low, inject glucagon or give

glucose gel.• Evacuate those who become worse or do not

recover.

Allergic Reactions (1 of 10)

• Can be mild and recurrent or sudden and severe.

• Anaphylactic shock: A massive allergic reaction with potentially fatal results.

Allergic Reactions (2 of 10)

• Anaphylactic shock – What to look for:

• Severe itching or hives• Sneezing, coughing, or wheezing• Shortness of breath• Tightness and swelling of the throat

and tightness in the chest

Allergic Reactions (3 of 10)

• Anaphylactic shock – What to look for:

• Dramatic swelling of the face, tongue, and/or mouth

• Vomiting, cramps, or diarrhea• Convulsions or loss of responsiveness

Allergic Reactions (4 of 10)

• Anaphylactic shock

– What to do:• Act quickly!

• Check breathing and give CPR if necessary.

• Administer epinephrine.

Allergic Reactions (5 of 10)

• Anaphylactic shock – What to do:

• Monitor condition very few minutes.• Give more epinephrine if necessary.• If you do not have epinephrine, use an

asthma inhaler or nasal decongestant spray or antihistamine.

• Allow conscious victims to assume a position of comfort.

Allergic Reactions (6 of 10)

• Anaphylactic shock – What to do:

• After victim improves, give diphenhydramine.

• If there is no improvement, evacuate immediately.

Allergic Reactions (7 of 10)

• Allergic rhinitis– What to look for:

• Itching of the nose, roof of the mouth, throat, and eyes

• Stuffy, runny nose and runny eyes• Sneezing

Allergic Reactions (8 of 10)

• Allergic rhinitis– What to do:

• Avoid the cause, if known.• Give antihistamines or

antihistamine/decongestant combinations.

Allergic Reactions (9 of 10)

• Hives– What to look for:

• Pink, blotchy, itching bumps on the skin• Occasional massive, itching swelling of a lip,

eyelid, hand, or foot

Allergic Reactions (10 of 10)

• Hives– What to do:

• Watch for signs of anaphylactic shock.• Give nonprescription antihistamines.