First Aide: For (diabetic) Dummies

Recently I’ve had a career change. I went from a meaningless, faceless job to a more fulfilling and gratifying career in personal care. I studied marketing in college. I have a knack for business and communications, so this is a far cry from anything I’ve done before.

Part of my required training was a mandatory emergency first aide class through St. John’s Ambulance. It was a fantastic course. I really enjoyed it. It’s something that I think everyone should do… put it in schools or something. It is a one day affair that covers CPR, severe bleeding, emergency burns, and the Heimlich maneuver (It is no longer to be called the Heimlich maneuver actually. Apparently the relatives of Dr. Heimlich wanted to be paid to use his name for this so they changed it. This was kind of a revelation for me. Seriously, what next? “I expect a 50 cent royalty every time someone chokes and is saved by my maneuver!” I have to physically resist rolling my eyes as I type this.)

Near the end of the day we reached a section of the program on special conditions. The first of these was diabetes. That morning we’d been given the first aide textbook. When we got to the section on diabetes I skimmed through the information on the page. I was a little dismayed but definitely unsurprised by what was listed there as to what to do in an emergency with a diabetic person.

I find that the diabetic medical community is really on the ball with the needs of diabetics. The doctors, nurses, and other health care workers really know their stuff. They seem to be well informed about the complexities of the illness both physical and emotional. It is the general medical community that seems to fall short. Their information is uneven and clumsy, sometimes sadly outdated. I don’t understand how an illness so dramatically widespread and so drastically on the rise, can be so widely misunderstood.

The advice of the St. John’s Ambulance textbook was not necessarily wrong… just incomplete, and therefore easily confusing for anyone not intimately familiar with the condition. There were two things that struck me when first reading this section; first, they list the signs and symptoms of someone suffering from either hypo or hyperglycemia. This list, the way it is written sounds absolute and very clear. That is what makes it so misleading. For example, exhaustion is listed for low blood sugars. But exhaustion and lack of energy can be a sign of both hyper and hypoglycemia. And it is so important to realize that each diabetic is different in their symptoms. In cases of extremely low sugars or extremely high sugars, dizziness, eyesight difficulties, and confusion are common. This textbook made it sound like these symptoms are strictly one or the other.

Ok… so contrary to what St. John’s ambulance would have us believe, if you are unfamiliar with diabetes it may not be easy to tell if the individual is suffering from high or low sugars. Now what?

The textbook says to give the person sugar. It has a delightful drawing of a woman sitting on the floor stating that she is confused, and a young man offering her something ( juice, I’m guessing) and saying “Here, this may help, and it definitely will not hurt.”

I was sitting in class trying to suppress my irritation.

I’ve had record high sugars. The highest recorded was something like 54. I was perfectly lucid and capable at the time. I’d driven myself to the hospital. I was a little sick but I wasn’t confused or unable to do things on my own. So what number would I have to reach before that happened? 60? 65? 75?

I don’t know.

So let’s say I get confused. And my first aide responder opens the textbook to the diabetes page and sees I’m confused and can’t breathe well and have no energy. They give me a glass of orange juice.

Then what?

Seizures? Coma? It only takes that juice seconds to do the job.

I couldn’t hold my tongue. I said some of this stuff to our first aide teacher. She responded by saying that the general rule of thumb was to give the person sugar… then wait 5 to 10 minutes because they should start to feel better right away. If they don’t, then the problem is high sugars and to call the ambulance.

Well ok.

That seemed fairly reasonable to me. In an emergency situation there are only so many options you have. However, nowhere in the book does it say any of this reasonable stuff! Just: “Give them sugar!”

Again: then what?

Well according to the book that’s it. So my poor inexperienced first aide responder thinks: “Ok, they are not better… more sugar?”

More sugar?!

How would they know what to do if I was too sick to tell them?

There is the flaw. Just a tiny bit more information and this risk is greatly diminished. One sentence: “If the sugar does not begin to revive the individual after 5 to 10 minutes, an ambulance needs to be called immediately.”

Sound reasonable?