Question for diabetics

[InsanityInc]

Actually this is for all posters who know anything about diabetes. One of my coworkers is a diabetic. Today he had a seizure. I came back in from getting lunch, and he was on the floor seizing. One of my coworkers had him propped up, and our boss was giving him sips of a soda. (He was able to drink, but otherwise out of it.) We had called 911, but due to flooding in the area the ambulance took a long time getting there.

If (and god I hope not) it happens again, what can we do for him? We don't know if he brings a meter to work, which I WILL be asking him about when he comes back. My mother is Type 2, so I do know how to test someone else, but she's never had this happen to her.

Also, none of us was comfortable in giving him an injection without A. knowing the best place to give one, and B. knowing what his sugar level was.

Does anyone have any tips on what we can do for him? Most of the employees are trained in first aid, but not anything this specific. I have the feeling this is going to change as one of the people present was our saftey manager who was freaked out both because of what happened, and because of our inability to do anything.

Thanks in advance for any and all advice.

[BookstoreEscapee]

For starters, you should ask him when he comes back what you should do if it happens again. If he's smart he will have a meter with him at all times. I know a girl who has Type I, and she has an insulin pump, but she always has her meter in her bag, and keeps a bottle of glucose tablets on her shelf over her desk at work.

You probably shouldn't be attempting to give him insulin, because, like you said, you don't know what his sugar level is so you can't know what dosage he needs. By the same token, I don't know if it's low blood sugar or low insulin that causes seizures (I think low sugar, judging from my experience with Pablo's last seizures before he died), or if either extreme can do it, so I don't know if giving him something sugary to drink helps or makes things worse. Also, giving him something to drink while he's out of it like that could cause him to choke on it, and if he's in the middle of a seizure he may not be able to cough it up.

What I know about seizures is more in the context of epileptic-type seizures, and basically there isn't much to do other than try to move the person to a safe space with no furniture or other objects they can be injured on, and call 911 for medical assistance. The 911 operator will ask questions and can tell you if there's anything else specific you should do while waiting for the ambulance, as well.

[sexiphatchick]

It's not so much a seizure as a diabetic attack. It can happen if the sugar gets too low. Best thing you can do is exactly what you did. Except in the future I wouldn't give him soda. It's not good for diabetics to have caffiene when they're in the middle of a diabetic attack. Best thing is orange juice.

DON'T try to give him insulin. Give him juice, and once he calms down enough, he should be able to give himself a shot if needed.

And if he's diabetic, he should have a machine and he should be USING it regularly.

[Buglady]

My first aid training was to make sure the person who is seizing is safe from hitting their head on anything (basically you clear any hazards out of the way), and wait for the seizure to pass. You never hold them down or try to restrain them because both you and the person seizing may get hurt - they don't have the usual restraint on muscle strength. (Most people are far stronger than they realize - we all suppress a lot of our own strength and muscle force).

You should call 911 if the person has never had a seizure before or if the seizure is more severe than previous ones. (Not every seizure requires an ambulance, but better to call one & not have it needed than the other way round!).

After the seizure is over you should encourage the person to stay lying down, preferably on their side. If they are unconscious, place them in the "recovery position" (on side, head supported, legs curled up a little - this helps prevent choking if they vomit, or having their tongue fall back and block the airway) and call 911 if you haven't already.

For diabetics, I believe the rule of thumb is to give them an easily absorbed form of sugar (honey, glucose tablet under the tongue, or glucose syrup), but never something they could choke on. If their blood sugar is too low, this will help, and if it's too high, it won't make a big difference because once the insulin shock starts that's it.

As others have said, check with your coworker for specifics.

[Eric the Grey]

Actually this is for all posters who know anything about diabetes. One of my coworkers is a diabetic. Today he had a seizure. I came back in from getting lunch, and he was on the floor seizing. One of my coworkers had him propped up, and our boss was giving him sips of a soda. (He was able to drink, but otherwise out of it.) We had called 911, but due to flooding in the area the ambulance took a long time getting there.

Like others have said, make certain the person doesn't hurt his/her head until they calm down and call 911 immediately. You office did right there.

If (and god I hope not) it happens again, what can we do for him? We don't know if he brings a meter to work, which I WILL be asking him about when he comes back. My mother is Type 2, so I do know how to test someone else, but she's never had this happen to her.

Checking blood sugar after any tremors have died down is not a bad step. You can relay that to the 911 operator, but do not attempt to give the person insulin. Even IF their blood sugar is high, it's unlikely the cause of a seizure in my experience.

Also, none of us was comfortable in giving him an injection without A. knowing the best place to give one, and B. knowing what his sugar level was.

You did right there. Do not give an injection to someone without knowing exactly why. If he has spells like this often, he may need a glucagon kit kept handy, which is a boost for blood sugar for when a diabetic is unconscious, but regardless, a person needs to be informed of how to use it, so it may well be a good idea for him to show a couple people how to use them.

Does anyone have any tips on what we can do for him? Most of the employees are trained in first aid, but not anything this specific. I have the feeling this is going to change as one of the people present was our saftey manager who was freaked out both because of what happened, and because of our inability to do anything.

Thanks in advance for any and all advice.

Coming from a Diabetic who has had to deal with a Diabetic father who regularly had fainting spells, it sounds like you guys did great, even given the caffeine thing. Sugar in liquid form as long as the person is awake and capable of drinking on their own is a good thing. Glucose tablets are better though.


Eric the Grey

[PentUpRage]

In the simplest of explanations, insulin and excercise brings your sugars down, stress and food send them up. You ONLY give insulin to lower sugars and ONLY if you know exactly how much to give as everyone is different and the calculations vary greatly.

I agree with Eric, chances are your co-worker had a glucagon kit on him and if not, he should have one at work minimally. For my daughter we have 3, one at her dads, one here with us and one in her bag to go with her to school etc.

If they are passed out and unable to chew a glucose tablet or drink on their own you can rub a gel into their mouth. Cake decorating gels work well as do Jr. Mints.

Regarding the glucagon kit, I have trained the staff at school and have printed directions for the classroom and the office. http://www.drugs.com/cons/glucagon-e...ood-sugar.html
The glucagon kit may very well stop the seizure and that is your goal. When a diabetic passes out they don't always sieze but that possibility is very likely. I told staff at my daughters school, if she passes out, administer glucagon, call 911 and THEN call me.

[malmalthekiller]

An episode can be caused by sugars being either too high or too low, which has happened to me, but not so much at that scale.

Hopefully he'll be more careful to keep his meter around with him now.

I'm glad to hear that he's doing alright, and that you guys all cared enough about him to want to know more to help him.

[fireheart]

I have two friends who have parents with Type 2 and my partner is also Type 2 so I do have some knowledge of how to deal with these situations.
While I can't say about what to do with the insulin, I'd suggest it'd be best to leave it to the paramedics or the hospital.
If you can, try and encourage them to keep some jellybeans nearby, even if it's with the First Aid kit. Some chemists may sell glucose jellybeans, which are designed for diabetics as far as I know. Glucose tablets may be hard to come by, so they work well as a backup.
Otherwise, maybe get them to have a talk with their manager to have a small snack at some part during the day, even if it is a jellybean or two, to bring their blood sugar up, especially if it's a recurring thing.

[InsanityInc]

Thanks guys. The heck of it was, he'd had a bowl of oatmeal a couple of hours before that, and was actually eating lunch when it happened. Tell you what, it's scary as hell seeing it happen. Unfortunatly soda was all we had to give him. One of the guys googled what to do as we were waiting for the ambulance and it was listed as being ok for an emergency.

Personally, I want to be prepared if something like this ever happens again. I've never asked because I figured it fell under TMI, and didn't want to make him uncomfortable, but I suspect he's Type 1. Before I left yesterday, we got word that he was doing ok, and was coming around.

[sexiphatchick]

Soda is fine in an emergency. Any kind of sugar is better than no sugar.

[Seshat]

When in doubt of what to do in a first aid emergency, make the patient safe and call emergency. (911 in the States, 000 in Australia, etc.) The emergency staff will tell you what else to do.

In other words: you did good. You acted on the best knowledge you had, and contacted someone (emergency) with greater knowledge. You did fine!



(Addendum here for future reference for anyone who doesn't already know...)

"Make the patient safe" means assessing the situation:
- if they're seizing, move away anything that could damage them if they hit it. If it can't be moved, pad it.
- if they're in the middle of the road and you can safely divert traffic, do so. If you can't, consider moving the patient.
- if there's a fire you can't quickly put out which is threatening the patient, move the patient. Ditto for flooding.
- if there's other risk, deal with it. Modifying the environment is better than moving the patient, but don't risk injuring another person to modify the environment!

Don't put yourself at risk for the sake of a patient, call emergency instead. Noone wants two patients instead of one.

If you have to move the patient but there's time to get advice, call emergency first. If not, go ahead and move the patient.

If there's more than one person, have one of you call emergency while the other is assessing the situation.

If the patient isn't breathing but you can detect a heartbeat, check that the airway is clear and help them breathe.
The tool which is always available for that is your own lungs: get a good breath, put your mouth over theirs, breathe out into their lungs. Don't force it, just breathe out as normally as you can. Get another good breath, while listening to see if they start breathing. (This is where people tilt their heads - they get an in-breath while their ear is over the patient's mouth.) Breathe into their lungs again.
Repeat until they breathe on their own.

If you can't detect a heartbeat but they are breathing, don't try CPR. If their heart wasn't beating, they wouldn't be breathing. Just be extra watchful.

If there's neither breath nor heartbeat, find someone who knows CPR. Or call emergency and get their advice, immediately. If you're reading this and you don't know CPR, call and book yourself in for first aid training. You'll feel awful if you find someone who needs CPR and you can't do it.