Thursday, July 22, 2010

FFL: The Power of One(plus One)

As I snuck into Tom Karlya's "Advocacy" session,it was obvious that I was pretty late to the game on this one.There was a slide with a flowchart of the governmental "pecking order",presumably to guide one in the "how do I make a difference?" process,& the conversation was on school nurses,etc.(& non-medical personal giving glucagon shots) I know nothing of IEP's and 504's and all that,I never had need of it but it's something that every parent of a kid with D needs to have in place,it seems.Then,the conversation switched to EMS & why they couldn't just give glucagon shots instead of IV's.That,I do know something about..but I do not understand people's reluctance toward IV glucose,if you need it,you need it.(seizing,etc) However,there was alot of confusion as to how the process actually worked..& who was responsible for those decisions & basically the room went dead silent for awhile. In my area,it was the medical director who wrote EMS/Fire protocols & I always figured it to be state law but I don't know.The medical director is an actual MD(& presumably based in Emergency Medicine?out of the ER where they take the patient?) but don't quote me on that,it's been years since I did that stuff.However,when you are unconscious,checking bg is something that should be on EVERY protocol,nationwide,there's no need to call up your local EMS unit & tell them you have diabetes.It's a "duh" moment that any loss of consciousness could be bg related(after ruling out heart,brain issues). (But it is always a good idea to wear medical identification jewelry,regardless) As a Basic EMT,I could give glucagon shots but never got to give one,the paramedics were generally all over the LOC with an IV line pumping D50.
Otherwise,it was treated with glucose gel,each ambulance carrying a grand total of three(not very useful for repeat diabetic calls),but then again,most EMT's have the idea that 15 grams glucose should bring you(in five seconds flat) from comatose to being able to run a marathon. Not quite how it works.(I blew through 3 & the bag of D-50 one day). However, I did see the need for parents,PWD to know slightly more about the process..you can't just call up local EMS & tell them this is how you want your lows treated.I don't even know if having a heart-to-heart with the medical director would result in protocol change.(likely not)There should be a national database where one can look up the protocol for "diabetes" related events so one can know what to expect. There's things EMS can do,and things they can't, & education is needed at both ends of the spectrum.It really bothers me that there's not more knowledge about this issue..& they complain about past experiences because they assume the EMT knows everything about D? (news flash,they don't.They know how to save a life,not how to restore a normal bg)

Regardless,Tom Karlya is one inspiring speaker & made me want to go out there & kick some diabetes posterior!

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3 comments:

Cara said...

I have a friend who is an EMT. She said, basically, the same thing you did. In my opinion, if you are calling EMS for a low blood sugar, then it's probably so bad that YOU can't call. Someone is calling for you. And D-50 is the quickest way to get the blood sugar up. Yes, it sucks on the person with diabetes (the nasuea, vomiting, high blood sugars, etc), but if you are that bad off, you need something quick.
Oh, and as for EMT's knowing everything about diabetes? Ha. I don't even expect my DOCTORS to know as much as I do. It's the nature of the beast. I assume no one knows anything. LOL

Scott K. Johnson said...

Thanks for this post Heidi. We talked a little bit about this in regards to George's situation. Sure does create some scary situations.

I echo your sentiments on Tom. He is an amazing guy and so dedicated to helping us. When he talks, we'd do well to listen.

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