scholarly journals P039: What are the frequencies of interventions performed by paramedics during seizure calls?

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S91-S91 ◽  
Author(s):  
D. Eby ◽  
J. Robson ◽  
M. Columbus
Keyword(s):  
Primary Care ◽  
Blood Sugar ◽  
Random Number ◽  
Descriptive Statistics ◽  
Scope Of Practice ◽  
Glucose Levels ◽  
Secondary Database ◽  
Blood Glucose Levels ◽  
Paediatric Age ◽  
Random Number Table

Introduction: Paramedics frequently attend out-of-hospital seizure patients. They administer oxygen, check blood glucose levels and if within scope of practice, start IVs and administer benzodiazepines. Little is know about how frequently these procedures are performed. The objective of this study was to determine the frequency of procedures performed by paramedics (Advanced Care (ACP), Primary Care IV (PCP-IV) and Primary Care non-IV (PCP)) attending seizure patients in a regional paramedic base hospital program. Methods: Retrospective analysis of a secondary database of ambulance call reports (ACRs) (January 01-December 31, 2014). All 2854 ACRs with paramedic determined primary / final problem codes of “seizure” were identified from total calls performed by 8 municipal paramedic services (MPSs), covering an urban and rural population of 1.4 million. MPSs used iMedic electronic ACRs. A 10% sample, generated using a random number table, was analyzed. ACRs were manually searched and data extracted onto spreadsheets. Findings were summarized using descriptive statistics. Results: 285 calls were analyzed; (adult 72.7%, paediatric (age <18) 27.3%). Paramedics witnessed seizures in 8.1% of all calls they attended; (paediatric 7.8%). The blood sugar was checked in 87.9% of adult calls; (ACP 88.7%, PCP-IV 89%, PCP 77.8%) and in 70.5% of paediatric calls; (ACP 72.0%, PCP-IV 63.3%, PCP 70.5%). Oxygen was administered in 80.7% of adult calls; (ACP 85.9%, PCP-IV 78.0%, PCP 80.7%) and 83.3% of paediatric calls; (ACP 92.0%, PCP-IV 80.1%, PCP 82.4%). IVs were started by paramedics (if in scope of practice) in 28.0% of adult calls; (ACP 47.9%, PCP-IV 16.1%) and 6.6% of paediatric calls; (ACP 8.0%, PCP-IV 5.6%) Midazolam was administered in 10.4% of ACP attended calls and in 91.0% of the calls were they witnessed seizures. Transport occurred in 93.2% of adult calls and 100% of paediatric calls. Conclusion: ACPs were more likely to perform procedures on seizure patients than PCPs or PC-IVs. Children were much less likely to have procedures performed on them - blood sugar checks, and IV starts - but more likely receive oxygen and be transported. These findings have training implications.

scholarly journals LO38: Hypoglycemia is a rare peri-seizure finding in pre-hospital patients

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S40-S41
Author(s):  
D. Eby ◽  
J. Woods
Keyword(s):  
Blood Sugar ◽  
Random Number ◽  
Recent Literature ◽  
Conventional Wisdom ◽  
Descriptive Statistics ◽  
Rural And Urban ◽  
Hospital Patients ◽  
Paediatric Age ◽  
Random Number Table

Introduction: Conventional wisdom states that hypoglycemia is a frequent peri-seizure phenomenon and must be tested for. Conventional wisdom also lists hypoglycemia as a cause of seizures. Recent literature disputes this. Paramedic medical directives continue to direct paramedics to determine the blood sugar level on all seizure patients. The purpose of this study was to determine the frequency of hypoglycemia in patients identified as having “seizure” as the primary or final problem code in Ambulance Call Reports (ACRs) from a large regional paramedic base hospital program. Methods: We conducted a retrospective analysis of iMedic platform, electronic ACRs, for a 2 year period (Jan 01, 2014 to Dec 31, 2015), from 8 Paramedic Services serving a rural and urban population of 1.4 million. 5854 calls, had “seizure” listed as a primary or final problem code. A 10% sample was generated using a random number table. ACRs were manually searched, data abstracted onto spread sheets, and the results analyzed using descriptive statistics (Wizard ver 1.8.16 for Mac). Results: 582 calls were analyzed. 430 (73.9%) were adults and 152 (26.1%) were paediatric (age &lt;18). A blood sugar was determined in 501/582 (86.1%) of all calls; adults 388/430 (90.2%), peadiatric 113/152 (74.3%). The Glasgow Coma Score, when measured, was 15 in 280/575 (48.7%) cases. Seizures were witnessed by paramedics in 47/582 (8.1%) calls; adults 33/430 (7.7%), paediatric 14/152 (9.2%). In calls were paramedics witnessed a seizure a blood sugar was determined 36/47 (76.6%) of the time; adults 25/33 (75.8%), paediatric 11/14 (78.6%). Hypoglycemia (BS&lt;4.0 mmol/L in an adult and 3.0 mmol/L in child&lt;age 2 ) was found in 1 case when BS was checked-overall 1/501 (0.2%); adults 1/388 (0.3%), paedatric 0/113 (0.0%). Case 1-age 70 yr, GCS 12, BS 3.8 mmol/L. Conclusion: Hypoglycemia was rarely found in patients who had a pre-hospital seizure. It did not require treatment. When it was found, hypoglycemia was unlikely to be the cause of the seizure. The results are similar to the findings from other recent, retrospective, reviews. The routine determination of blood sugars in all patients who have had a seizure prior to paramedic arrival should be reconsidered.

scholarly journals P038: How frequently is hypoglycemia found in ambulance calls for “seizure”?

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S91-S91
Author(s):  
D. Eby ◽  
J. Robson ◽  
M. Columbus
Keyword(s):  
Retrospective Analysis ◽  
Blood Sugar ◽  
Rural Population ◽  
Random Number ◽  
Recent Literature ◽  
Hospital Setting ◽  
Summary Statistics ◽  
Paediatric Age ◽  
Random Number Table

Introduction: Paramedics often attend seizure patients in the pre-hospital setting. Received wisdom is that hypoglycemia is frequently present during a seizure or is a ‘cause’ of seizures. Recent literature disputes this. The purpose of this study was to determine the frequency of hypoglycemia in patients identified as having “seizure” listed as the primary or final problem code in Ambulance Call Reports from a large regional paramedic base hospital program. Methods: Retrospective analysis of a database of ambulance call reports (ACRs) from January 01-December 31, 2014. All 2854 ACRs with paramedic determined primary or final problem codes of “seizure” were identified from a database of all calls performed by 8 municipal paramedic services covering a total urban and rural population of 1.4 million. Municipal paramedic services used iMedic electronic ACRs. A 10% sample generated by a random number table was analyzed. ACRs were manually searched and data extracted onto spreadsheets. Results were described using frequencies and summary statistics. Results: A total of 285 call were analyzed. 207 (72.6%) calls were adults and 78 (27.4%) were paediatric (age <18). Seizures were witnessed by paramedics in 23/285 (8.1%) calls; adults 17/207 (8.2%), paediatric 6/78 (7.7%). A blood sugar was determined in 237/285 (83.2%) of all calls; adults 182/207 (87.9%), paediatric 55/78 (70.5%). In calls were paramedics witnessed a seizure a blood sugar was determined 17/21 (80.9%) of the time; adults 13/17 (76.5%), paediatric 6/6 (100%) Hypoglycemia (BS < 4.0 mm/L) was found in only 1 case - 1/237 (0.4%); adults 0/ 207 (0%), paediatric 1/78 (1.3%). The child was age 1, had a GCS 13, and the blood sugar was 3.9 mm/L. Conclusion: Hypoglycemia was rarely found in patients who had a seizure and were attended to by paramedics in the pre-hospital setting. The routine determination of blood sugars in all patients who have had a seizure prior to paramedic arrival should be reconsidered.

scholarly journals PENGARUH JUS LIDAH BUAYA TERHADAP KADAR GLUKOSA DARAH PUASA DAN 2 JAM PP(Post Prandial) PADA PENDERITA DIABETES MELITUS

2019 ◽  
Vol 10 (1) ◽  
pp. 77
Author(s):  
Febria Syafyu Sari ◽  
Ridhyalla Afnuhazi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Sugar ◽  
Fasting Blood Glucose ◽  
Aloe Vera ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Patients With Diabetes ◽  
Paired T Test ◽  
Diabetes Melitus

ABSTRAK Diabetes Melitus merupakan penyakit yang paling menonjol yang disebabkan oleh gagalnya pengaturan gula darah. Lidah buaya berkhasiat untuk menurunkan kadar gula dalam darah bagi penderita diabetes dan dapat mengontrol tekanan darah. Tujuan penelitian untuk mengetahui pengaruh jus lidah buaya (AloeBarbadensis Miller) terhadap penurunan glukosa darah puasa GDP) dan 2 Jam PP (Post Prendial) pada penderita DM (Diabetes Melitus). Desain penelitian merupakan Quasi Eksperimental dengan pendekatan one group pretest – postest design. Sampel terbagi menjadi 14 responden. Data dianalisis dengan paired t-test. Hasil menunjukan rata-rata penurunan glukosa darah puasa pada intervensi (28,42 gr/dl) dan glukosa darah 2 jam pp pada intervensi (40,57 gr/dl). Untuk analisis bivariat terdapat perbedaan antara glukosa puasa dan 2 jam pp dengan glukosa darah puasa GDP) dan 2 Jam PP (Post Prendial) pada penderita DM (Diabetes Melitus). Kesimpulan didapatkanlidah buaya dapat menurunkan kadar glukosa darah.Berdasarkan hasil penelitian jus lidah buaya dapat menjadi salah satu alternatif keperawatan non farmakologi dalam penyakit diabetes melitus. Kata Kunci : Lidah Buaya ; Diabetes Mellitus THE EFFECT OF VEGETABLE VOCATIONAL JUICE ON FAST BLOOD GLUCOSE LEVELS AND 2 HOURS OF PP (Post Prandial) IN DIABETES MELLITUS  ABSTRACT Diabetes mellitus is the most prominent disease caused by the failure of blood sugar regulation. Aloe vera is efficacious can to  reduce blood sugar levels for diabetics and can control blood pressure. The purpose of this study was to determine the effect of Aloe Barbadensis Miller on the reduction of fasting blood glucose GDP and 2 hours of PP (post prendial) in patients with diabetes mellitus. The research design is Experimental Quasi with one group pretest - postest design approach. The sample is divided into 14 respondents. Data were analyzed by paired t-test. The results showed an average decrease in fasting blood glucose at intervention (28.42 gr / dl) and 2 hours pp blood glucose at intervention (40.57 gr / dl). For bivariate analysis there was a difference between fasting glucose and 2 hours pp with fasting blood glucose GDP) and 2 hours PP (Post Prendial) in patients with diabetes mellitus. The conclusion is that aloe vera can reduce blood glucose levels. Based on the results of research on aloe vera juice can be an alternative non-pharmacological nursing in diabetes mellitus. Keywords: Aloe Vera ; Diabetes Mellitus

scholarly journals UJI AKTIVITAS ANTIDIABETES KOMBINASI EKSTRAK ETANOL DAUN ECENG GONDOK (Eichhornia crassipes (Mart.)Solms) DAN DAUN SINTRONG (Crassocephalum crepidioides (Benth.) S. Moore) PADA MENCIT

2021 ◽  
Vol 4 (1) ◽  
pp. 44-53
Author(s):  
Andri Priyoherianto ◽  
◽  
Panji Ratih Suci ◽  
Putri Rizki Cahya Fatimah ◽  
Atik Nur Wijayanti
Keyword(s):  
Blood Glucose ◽  
Blood Sugar ◽  
Water Hyacinth ◽  
Leaf Extract ◽  
Positive Control ◽  
Negative Control ◽  
Glucose Levels ◽  
Normal Limits ◽  
Blood Glucose Levels ◽  
Sugar Levels

Diabetes mellitus is a chronic metabolic disorder that occurs due to destruction of pancreatic ? cells characterized by blood glucose levels that exceed normal limits. The purpose of this study was to determine the therapeutic effect of the combination of water hyacinth leaf extract and Sintrong leaf in reducing blood glucose levels in alloxan-induced experimental animals. Water hyacinth leaf powder and Sintrong leaves were extracted using the maceration method with 70% ethanol as a solvent. A total of 25 mice were divided into 5 groups, namely negative control CMC-Na 0.5%, positive control glibenclamide 0.00065 mg / g BW, water hyacinth leaf extract 17.5 mg / kg BW, Sintrong leaf extract 10.5 mg/ kg BW and a combination of water hyacinth leaf extract 17.5 mg / kg BW and sintrong leaf 10.5 mg / kg BW. The results showed that a single extract of water hyacinth and Sintrong leaves was able to reduce blood sugar levels for 7 days. The combination dose was effective in reducing blood sugar levels with a combination dose of 17.5 mg/ kg water hyacinth leaf extract in combination for 7 days.

scholarly journals MP10: How dry I am: how much fluid do paramedics give when they administer an IV fluid bolus?

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S68
Author(s):  
D. Eby ◽  
J. Woods
Keyword(s):  
Primary Care ◽  
Random Number ◽  
Bolus Administration ◽  
Further Training ◽  
Bolus Volume ◽  
Initial Sample ◽  
Fluid Bolus ◽  
Procedure Code ◽  
Random Number Table ◽  
The Mean

Introduction: How is “administer a fluid bolus” interpreted by paramedics? There is no existing literature describing this practice in the prehospital setting. Paramedic medical directives authorize the administration of Normal Saline 20 ml/kg to hypotensive patients (systolic BP &lt;90). Anecdotally, auditors of Ambulance Call Reports (ACRs) and paramedics report this amount of fluid is rarely administered. The aim of this study was to determine the amount and rate of IV fluid administered by Advanced Care (ACP) and Primary Care (PCP) paramedics when they give an IV ‘fluid bolus’ during an ambulance call. Methods: We conducted a retrospective analysis of iMedic platform, electronic, ACRs (January 01, 2015 to June 30, 2015) from 8 municipal paramedic services that serve an urban and rural population of 1.4 million. ACRs containing a procedure code 351 (intravenous fluid bolus) were identified. A stratified, random sample of 20 cases per paramedic category (ACP and PCP) from each service was generated using a random number table. ACRs were manually searched, data abstracted onto spread sheets, and the results analyzed using descriptive statistics (Wizard ver 1.8.16 for Mac). Results: The initial sample was 220 cases. 25 were excluded for incomplete documentation, leaving 195 cases (ACP 59, PCP 136) for analysis. The mean IV fluid bolus volume delivered was: ACP 414.8 ml (95%CI: 344.2, 485.4), PCP 242.3 ml (95%CI: 210.9, 274.5). The mean rate of infusion was: ACP 22.7 ml/min (95%CI: 17.6, 27.8) PCP 15.7 ml/min (95%CI 13.2,18.1). Percentage of cases where &gt;250 ml was infused: ACP 74.6%, PCP 44.1%. Percentage of cases where at least 10 ml/kg of fluid was given: ACP 17.0%, PCP 2.9%. Percentage of cases reaching the maximum 20 ml/kg of fluid: ACP 0.5%, PCP 0%. IV cannula size: 18G-ACP 57.4%, PCP 33.3%; 20G ACP 37.0%, PCP 56.8; 22G ACP 0.6%, PCP 9.8%. Conclusion: Paramedics rarely gave the amount of IV fluid they were authorized to give to hypotensive patients. On average, Advanced Care Paramedics administered significantly more fluid and gave it significantly faster than Primary Care Paramedics. ACPs were more likely than PCPs to use 18G cannulas and rarely used 22G cannulas whereas PCPs preferred to use 20G IV cannulas. Further training is required to clarify and improve the paramedic practice of IV bolus administration.

BLOOD GLUCOSE LEVEL IN MICE.

1966 ◽  
Vol 52 (3) ◽  
pp. 357-367 ◽  
Author(s):  
Claus Rerup ◽  
Ingmar Lundquist
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Blood Sugar ◽  
Glucose Level ◽  
Enzymatic Reaction ◽  
Sampling Procedure ◽  
Experimental Conditions ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Blood Sugar Response

ABSTRACT Multiple serial blood glucose level determinations in individual mice were performed on small blood samples (10–25 μl) using the orbital bleeding technique. Glucose was determined specifically by a known enzymatic reaction. Blood glucose determined in this way was found a parameter of high reproducibility and precision, the latter being shown by the finding that differences between individual animals were highly significant in practically all the experiments. The standard deviation of the single measurement in normal mice was ± 8.2 mg/100 ml as determined from 600 samples, which indicated that the technique allows of the detection of blood sugar level changes of about 15 mg/100 ml or more with very high significance, in a group of 5 mice. In the sampling procedure as such, intravenous or subcutaneous saline injections did not necessarily have any effect on the blood glucose level, but interpretation of slight blood sugar changes under experimental conditions should always be based on a comparison with control groups, since the latter may sometimes show a slight but significant change. In normal non-fasting mice (NMRI strain) significant differences in homoeostatic blood glucose level adjustments were demonstrated. In acutely adrenalectomized mice blood glucose levels were lower and more variable than in normals. Alloxan injection (70 mg/kg) was followed in individual mice by a triphasic blood sugar response, as is known from other species.

scholarly journals THE EFFECTS OF CORN FLOUR WITH TEMPEH FLOUR SUPPLEMENTATION FEEDING IN DIABETES MELLITUS WISTAR RATS TOWARD BLOOD GLUCOSE LEVEL

2017 ◽  
Vol 4 (2) ◽  
pp. 24
Author(s):  
Fatifa Asmarani ◽  
Bambang Wirjatmadi ◽  
Merryana Adriani
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Sugar ◽  
Wistar Rats ◽  
Control Group ◽  
Standard Diet ◽  
Corn Flour ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Sugar Levels

Background: Diabetes mellitus (DM) is metabolic disorder syndrome characterized by hyperglycemia due to deficiency of insulin secretion. Patients of diabetic patients increases each year, so it needs proper handling. Corn flour is a source of carbohydrates with a low glycemic index to help reduce the rise in blood sugar levels. In addition, supplementation with tempeh flour containing isoflavones act to protect cells from free radical thereby inhibiting damage cells. Fiber in tempeh affect blood glucose levels because it slows the absorption of glucose.Objective: To determine the effect supplementation of corn flour with tempeh flour on blood sugar levels in diabetes mellitus Wistar rats.Methods: The study was true experimental design with Pre-posttest control group design, samples were 20 male Wistar rats aged 2-3 months were then divided into 4 groups (T0, T1, T2, T3.) T0 was injected with alloxan as 30 mg / 150 grams of BB rats are subsequently treated with standard diet; T1 was dministered by standard diet 50% + 50% corn flour; T2 was administered by standard diet 50% + 30% + corn flour tempeh flour 20%; and T3 was administered by standard diet of corn flour 50% + 15% + 35% tempeh flour for 2 weeks. Blood glucose levels were measured with a glucose kit (GOD FS). Research data were analyzed by One Way ANOVA followed by Tukey's Post Hoc test p-value <0.05.Results: There were significant differences on blood sugar levels in all groups (p = 0.000): control group (only dietary standards), T1 (administered by standard diet 50% + corn flour 50%), T2 (administered by a standard diet 50% + cornstarch 30% tempeh flour + 20%) and T3 (administered by standard diet of corn flour 50% + 15% + 35% tempeh flour).Conclusion: corn flour with tempeh flour supplementation effect on decresing of blood sugar levels.

scholarly journals Empowerment Strategies Through Coaching Interventions on Controlling Blood Sugar Levels the Elderly

2020 ◽  
Vol 2 (1) ◽  
pp. 65-72
Author(s):  
Desi Deswita ◽  
Sefrizon Sefrizon ◽  
Anita Mirawati ◽  
Zulharmaswita Zulharmaswita ◽  
Yudistira Afconneri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Sugar ◽  
Intervention Group ◽  
The Elderly ◽  
Glucose Levels ◽  
Consecutive Sampling ◽  
Blood Glucose Levels ◽  
Coaching Intervention ◽  
Quasi Experimental ◽  
Sugar Levels

The problem of elderly diabetes mellitus is complex and various interventions in the form of education have been carried out in controlling blood sugar levels but the results have not been optimal. Based on this, the researcher wants to know the effect of coaching intervention on controlling blood sugar levels of the elderly with diabetes in Indonesia. The quasi-experimental research design uses a treatment group. Sampling with consecutive sampling in which the intervention group was selected according to purpose, with 38 respondents. Independent t-test was used. The results obtained were significant differences in blood sugar levels after being given an intervention. Coaching interventions affect blood sugar levels of the elderly with diabetes. It was concluded that coaching interventions reduce blood sugar levels and provide opportunities for nurses to develop promotive and preventive efforts.  Keywords: blood glucose levels, coaching intervention, elderly

scholarly journals Korelasi Lingkar Pinggang dengan Kadar Gula Darah Puasa, Kadar Trigliserida, dan Tekanan Darah pada Mahasiswa Fakultas Kedokteran Universitas HKBP Nommensen

2021 ◽  
Vol 3 (2) ◽  
pp. 08-13
Author(s):  
Ervina Julien Sitanggang
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Young Adults ◽  
Blood Glucose ◽  
Waist Circumference ◽  
Blood Sugar ◽  
Fasting Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Sugar Levels

Introduction: Cardiovascular disease is the number one cause of death globally with an incidence of adolescents and young adults in Indonesia as many as 153.705 cases. Central obesity is associated with the risk of cardiovascular disease due to increase in fasting blood glucose levels, cholesterol and triglyceride levels, and blood pressure. Aims: to determine the correlation between waist circumference and fasting blood glucose levels, triglyceride levels, and blood pressure in young adults. Method: This analytic study with a cross-sectional approach involved 53 young adult subjects (18-25 years old). Waist circumference is measured using a tape measure. Blood sugar and triglyceride levels were measured using Cobas® 6000 analyzer machine from blood samples of subjects after fasting for 8-12 hours. Blood pressure data are obtained by measurement using aneroid sphygmomanometer. Results: In this study, the mean waist circumference of the research subjects was 77,4 cm. No correlation was found between waist circumference and fasting blood sugar levels (p = 0,159). However, a positive correlation was found between waist circumference and triglyceride levels (p = 0,008; r = 0,332), between waist circumference and systolic blood pressure (p = 0,049; r = 0,230), and between waist circumference and diastolic blood pressure (p = 0,017; r = 0,293). Conclusion: waist circumference is positively correlated with triglyceride levels and blood pressure, but does not correlate with fasting blood sugar levels.

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