Home > Medical Manuals > Intro Nursing Manual > Cerebrovascular Accident

The diabetic under treatment tries to balance the use of insulin against glucose intake to avoid the above problems. Diabetic ketoacidosis most often results either from forgetting to take insulin or from taking too little insulin to maintain a balanced condition. The victim or the victim’s family may be able to answer two key questions:

Has the victim eaten today?

Has he or she taken the prescribed insulin?

If the answer is yes to the first and no to the second question, the victim is probably in a diabetic coma.

Emergency first aid centers around ABC support, administration of oral or intravenous fluids to counter shock, and rapid evacuation to a medical officer’s supervision.

Insulin Shock

Insulin shock results from too little sugar in the blood (hypoglycemia). It develops when a diabetic exercises too much or eats too little after taking insulin. This is a very serious condition, because glucose is driven into the cells to be metabolized, leaving too little in circulation to support the brain. Brain damage develops quickly. Signs and symptoms include:

Pale, moist skin.

Dizziness and headache.

Strong, rapid pulse.

Fainting, seizures, and coma.

Normal respiration and blood pressure.

Treatment is centered on getting glucose into the system quickly to prevent brain damage. Placing sugar cubes under the tongue is most beneficial. Transport the victim to a medical treatment facility as soon as possible.

NOTE: If you are in doubt as to whether the victim is in insulin shock or a ketoacidotic state, give sugar. Brain damage develops very quickly in insulin shock and must be reversed immediately. If the victim turns out to be ketoacidotic, the extra sugar will do no appreciable harm since this condition progresses slowly.

CEREBROVASCULAR ACCIDENT

A cerebrovascular accident, also known as a stroke or apoplexy, is caused by an interruption of the arterial blood supply to a portion of the brain. This interruption may be caused by arteriosclerosis or by a clot forming in the brain. Tissue damage and loss of function result.

Onset is sudden, with little or no warning. The first signs include weakness or paralysis on the side of the body opposite the side of the brain that has been injured. Muscles of the face on the affected side may be involved. The level of consciousness varies from alert to nonresponsive. Motor functions on the affected side are disturbed, including vision and speech, and the throat may be paralyzed.

First aid is mainly supportive. Special attention must be paid to the airway, since the victim may not be able to keep it clear. Place the victim in a semireclining position or on the paralyzed side.

Be prepared to use suction if the victim vomits.

Act in a calm, reassuring manner, and keep onlookers quiet since the victim may be able to hear what is going on.

Administer oxygen to combat cerebral hypoxia.

Carefully monitor vital signs and keep a log. Pay special attention to respirations, pulse strength and rate, and the presence or absence of the bilateral carotid pulse.

Transport the victim to a medical treatment facility as soon as possible.

ANAPHYLACTIC REACTIONS

This condition, also called anaphylaxis or anaphylactic shock, is a severe allergic reaction to foreign material. Penicillin and the toxin from bee stings are probably the most common causative agents, although foods, inhalants, and contact substances can also cause a reaction. Anaphylaxis can happen at any time, even to people who have taken penicillin many times before without experiencing any problems. This condition produces severe shock and cardiopullmonary failure of a very rapid onset. Because of this, immediate intervention is necessary. The general