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Medical: 5 Endocrinology: 4

    • b.

      High flow oxygen

  • 2.

    Circulatory support

    • a.

      Monitor blood pressure

  • 3.

    Pharmacological interventions

    • a.

      Consider initiating intravenous line

    • b.

      Avoid interventions which mask signs and symptoms

  • 4.

    Non-pharmacological interventions

    • a.

      Monitor LOC

    • b.

      Monitor vital signs

  • 5.

    Transport consideration

    • a.

      Appropriate mode

    • b.

      Appropriate facility

  • 6.

    Psychological support

    • a.

      All actions reflect a calm, caring, competent attitude

    • b.

      Keep patient and significant others informed of your actions

  • III.

    Specific illnesses

    • A.

      Diabetes mellitus

      • 1.

        Epidemiology

        • a.

          Incidence

        • b.

          Morbidity/ mortality

        • c.

          Long term complications

        • d.

          Risk factors

        • e.

          Prevention strategies

      • 2.

        Anatomy and physiology review

      • 3.

        Pathophysiology

        • a.

          Types

          • (1)

            Type I-insulin dependent

          • (2)

            Type II-non insulin dependent

        • b.

          A chronic system syndrome characterized by hyperglycemia caused by a decrease in the secretion or activity of insulin

        • c.

          Normal insulin metabolism

          • (1)

            Produced by beta cells in the islets of Langerhans

          • (2)

            Continuously released into the bloodstream

            • (a)

              Insulin is released from the beta cells as proinsulin

            • (b)

              Routed through the liver where 50-70 percent is extracted from the blood

            • (c)

              The level of plasma insulin rises after a meal

              • i)

                Stimulates storage of glucose as glycogen, liver and muscle tissue

              • ii)

                Enhances fat deposition in adipose tissue

              • iii)

                Inhibits protein degradation

              • iv)

                Accelerates protein synthesis

            • (d)

              The fall of plasma insulin levels during normal overnight fasting facilitates the release of

              • i)

                Stored glucose from the liver

              • ii)

                Protein from muscle tissue

              • iii)

                Fat from adipose tissue

            • (e)

              Average daily secretion is 0.6 units per kilogram of body weight

          • (3)

            Activity of released insulin

United States Department of Transportation National Highway Traffic Safety Administration Paramedic: National Standard Curriculum

6

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