00:01
Now, you know what hypoglycemic
can likely look like in a patient.
00:05
Let's talk about how we want
to educate them to treat it.
00:08
Now if the patient has mild
to moderate hypoglycemia,
they're still able to think clearly,
they just don't feel very good.
00:15
We can probably fix this with
some carbohydrate rich food
if they're able to swallow.
00:20
Okay, so mild and moderate,
carbohydrate rich food
if they can swallow we're
going to be good to go.
00:25
But important before
they start this process
we want them to check
their blood sugar.
00:32
So you need an assessment first.
00:34
You don't feel so good.
00:35
Check your blood sugar
to find out how bad it.
00:39
Is that determines
what we do next.
00:41
Remember you're gathering
data looking at clinical cues
before you make an
effective clinical judgment.
00:47
Check the blood sugar if it's
less than 70 and they can swallow.
00:51
It's okay.
00:51
Let's just look at what we can do
with some carbohydrate reach food,
but we want to do it right away.
00:58
So let me give you some
examples you're looking about
15 grams of carbohydrates.
01:03
So in case you're not
real familiar with that,
let's just throw out some ideas.
01:07
They could take three
glucose tablets.
01:09
They could have 1/2 cup or
four ounces of fruit juice
or regular non-diet soda,
so you can have a
real coke right?
Not the full 12 ounce can,
but it have about a third of
that and that should help,
they could pop in five
or six hard candies,
they could take some sugar
and dissolve it in water
or just eat it plain they
could have a teaspoon of honey.
01:33
All of these are options
that will give you about
15 grams of carbohydrates.
01:39
So they start feeling
kind of wonky,
check their blood sugar,
see that it's mild to moderate.
01:44
They're still able to swallow.
01:45
So they take about 15
grams of carbohydrates in
and then wait 15 minutes.
01:52
15 grams of carbs,
wait 15 minutes.
01:55
15 grams of carbs,
wait 15 minutes.
01:59
15 gram of carbs
and wait 15 minutes,
as long as you're not in a dangerous
zone, you should be fine,
if they wait about 15 minutes
before they eat anymore
because we don't want them to...
02:11
raise their blood
sugar up too quickly.
02:13
So be careful not
to eat too much
to cause a super high blood sugar
and possibly even weight gain.
02:20
So that's how we would
treat that mild to moderate
so you can check your blood
sugar again in 15 minutes
if they don't feel
better in 15 minutes
and the blood sugar is
still lower than 70,
have them eat something again and just
repeat the process every 15 minutes
until you can get the blood
sugar back with a normal.
02:38
Now they may need
to eat a snack,
with their carbohydrates
and protein,
if your blood sugar is
now within the safe range.
02:44
So let's say my
blood sugar was low.
02:47
I checked it. I know it slow.
02:50
So I ate my
carbohydrate-rich snack,
I waited 15 minutes,
Check my blood sugar again,
then if it's okay,
if I think it's within a normal range
and I feel okay,
I might need to eat
something with some protein
because the next meal is like this longer
than an hour an hour and a half away.
03:08
So I'm going to eat some
protein just to help maintain
this healthy blood sugar.
03:13
So you see some five there.
03:14
You may eat a snack with
carbohydrates and protein
if your blood sugar is still
right around that 70 range
if it's a while
until your next meal.
03:23
Now last step if nothing works.
This is an emergency.
03:27
So if these five steps
that I've laid out
if they don't work for raising your
blood sugar to a healthy range,
you need to call the
physician right away
or get straight to the hospital.
03:38
So that's how we treat mild
to moderate hypoglycemia.
03:42
You have those five steps, what you
recognize, you check your blood sugar,
you try a simple snack,
re-check your blood sugar.
03:49
Once you get it stabilized you can
add a little extra snack on there,
if mealtime is an
hour or so away.
03:56
Now a severe hypoglycemia.
03:58
This is not going to be fixed
with a carbohydrate snack
or the patient is
unable to swallow.
04:04
We can use IV or
we can use a Sub-Q.
04:08
Let me talk about
the differences.
04:10
IV glucose will raise
the glucose immediately,
but you can only use that
in a hospital setting.
04:16
So IV,
you already know absorption,
There isn't any, if absorption is
the route of entry to the bloodstream
with IV Administration,
we put it right in
the bloodstream.
04:28
So glucose,
that's raised immediately,
but it's not available for home use.
04:34
Now Sub-Q glucagon.
04:36
Hey, that sounds familiar.
04:39
Glucagon that's like that
hormone in my pancreas
that raises my blood sugar.
04:45
Exactly!
Now this sub Q takes about
20 minutes for a response.
04:50
You can use it at home and it encourages
the glycogen breakdown in the liver.
04:55
Now you're going to Need
food when you can swallow
when that blood sugar
starts to raise up
to keep that blood
sugar normal and stable,
but it'll take about 20 minutes
for that Sub-Q glucagon to kick in.