First Aid for Diabetic Coma: Algorithm of Action
Diabetic coma is a very serious complication of diabetes mellitus that occurs due to an acute shortage of insulin in the body or with a disorder in the utilization of glucose by soft tissues.
As a rule, this condition develops in severe diabetes, but it can also occur with an insulin-independent form of pathology. In addition, this pathological condition develops regardless of whether the person undergoes treatment or is absent.
In modern medical practice, a diabetic coma is divided into the following types: ketoacidotic, hyperosmolar and hyperlactacidemic.
A coma against the background of diabetes is fraught with numerous complications that pose an immediate threat to the patient’s life. Therefore, it is necessary to understand what constitutes first aid for a diabetic coma, and what should be the algorithm of action?
Types of coma in diabetes
Ketoacidotic coma is the most common, and in the vast majority of cases develops with the first type of sweet disease. It is also called hyperglycemic coma.
As a rule, a pathological condition is characterized by rather rapid progression within a few hours. However, it can develop over several days.
The body is poisoned by ketone bodies and acetone, and due to a deficiency of glucose, cell tissues begin to “take” the energy reserve from protein components and fats, but not from sugar. This whole chain leads to the development of a coma.
A brief description of the types of coma:
- Hyperosmolar coma is observed much less frequently than its diabetic appearance. However, in approximately 50% of cases, the patient is fatal. This condition is characterized by sharp and severe dehydration of the body against the background of the absence of poisoning thereof with ketone bodies and acetone.
- Hyperlactacidemic coma develops extremely rarely, and most often this pathological condition affects diabetics of the elderly age group, who have a history of chronic diseases of the cardiovascular system, liver and kidneys.
As for the last type of coma, it develops as a result of intoxication of the human body with lactic acid.
It should be noted that the patient does not immediately fall into a coma, as a rule, this condition is preceded by precoma.
You can determine this condition by the following symptoms: severe lethargy, blurred consciousness, narrowing of the pupils.
Hypoglycemic condition: detection and relief
As mentioned above, hypoglycemia is more often observed in diabetics who have a history of type 1 disease. However, in medical practice there have been cases that this type of coma developed in patients who take pills to lower sugar.
Usually, before the development of a pathological condition, a sharp jump in insulin occurs in the body of the diabetic. The main danger is that there are irreversible changes in the central nervous system, the brain is disturbed.
Hypoglycemia can occur under the influence of negative factors. For example, the patient injected himself with excessive amounts of insulin, or he had a severe shock. Also, such a development of events can be affected by physical overload, a small amount of carbohydrates consumed with food.
What to do in this case, and how to help the patient? If the patient has a mild attack characterized by weakness, apathy, nervous excitement, excessive sweating, then something sweet will help correct the situation. For example, candy, a few spoons of jam or something else.
If the patient has severe symptoms, and he almost loses consciousness, then the following measures must be taken:
- Give the patient a sweet drink (for example, tea with honey). If a person is not able to drink it on his own, then you need to slowly pour liquid into the patient’s mouth using a teaspoon.
- Before drinking a diabetic, it is recommended to insert a fixator between his teeth.
- Feed the patient. There should be a lot of carbohydrates in food.
- The next day, reduce the dose of the hormone by several units (4-8).
If the diabetic faints, then an emergency team must be called in urgently, and then about 50 ml of glucose should be administered intravenously to the patient.
Hyperosmolar coma and first aid
As practice shows, such a pathological condition most often develops in people of the elderly age group. Typically, patients crossed a 50-year milestone. And to whom it is possible to characterize as moderate.
The reasons that led to the emergence of poor health, many. The most common of them: malnutrition, surgical intervention, pathology of infectious etiology, disruption of the gastrointestinal tract and others.
How to understand that the patient has a hyperosmolar coma? In order to detect a pathological condition in time, it is necessary to understand what symptoms it is characterized by:
- Two to three days before a coma, the patient constantly feels thirst, abundant and frequent urination, severe lethargy are observed.
- Drowsiness appears, the speech apparatus is disturbed.
- Hallucinations may develop.
With the development of such signs, the patient urgently needs first aid for diabetes. First of all, what needs to be done is to place the person in a horizontal position. Further, it is required to exclude a tongue retraction so that the patient does not suffocate.
It is necessary to measure blood pressure, inject 5-25 ml of glucose. If these measures do not help, the condition worsens, then everything indicates acute poisoning of the body, so you need to call an ambulance team.
After the patient is placed in intensive care, sugar in the body and blood osmolarity are constantly monitored.
Ketoacidotic coma: how to help a diabetic?
The development of this pathological condition is a consequence of many negative factors and circumstances. As a rule, the following points lead to it: late detection of a sweet disease, improper therapy, poor nutrition, purulent infections.
And also, surgical intervention, serious injuries, the birth of a child or the period of his bearing, acute vascular pathologies, severe stress and nervous overloads can provoke the condition.
We can say that such a pathological condition is mild and severe. If the patient has a mild form, this is detected by frequent trips to the toilet, sleep disturbance, lethargy, constant desire to drink as much fluid as possible.
When the condition worsens, the following clinical picture is revealed:
- The smell of ripe apples appears from the oral cavity.
- Respiratory failure. The patient breathes deeply, hoarsely.
- The skin turns pale, dry.
- Cold to the lower limbs.
- Acute pain in the abdomen.
If nothing is done at the stage of such symptoms, then the patient becomes inhibited, and then falls into a coma.
The first thing a person next to a diabetic should do is to call medical specialists. After that, it is required to check the vital functions of the patient – whether the heart is beating, whether there is a pulse, how the patient is breathing, to measure blood pressure.
The main task is to help the patient hold out until the arrival of the doctors. As a rule, doctors begin therapy with the introduction of the hormone in small doses, gradually increasing them. And the patient is hospitalized in the intensive care unit.
Diabetes mellitus belongs to the group of those pathologies that provoke serious complications, up to disability and death. Therefore, it is necessary to follow a low-carb diet and constantly monitor blood sugar to prevent negative consequences.