Hypoglycemic coma: emergency treatment. How to help before the arrival of a doctor?

A hypoglycemic state, when the blood sugar decreases (glucose), there may be every person, especially those who suffer from diseases of the exocrine pancreas. Hypoglycemic coma, an emergency in which it is very important in the shortest time, is almost always the destiny of diabetics. The most common sufferers are those who have a fairly "decent" experience of diabetes first (insulin-dependent) type.

What is terrible hypoglycemic coma? Damage to the nervous system, more specifically - edema of the brain. The fact is that almost half of the glucose entering the body is used by the brain. If there is a hypoglycemic coma, emergency help is delayed, the brain lacks energy, it can not work at full strength, that is, it includes a "sleep regime". Prolonged presence in this mode exacerbates the situation, since blood without glucose can retain less water in it (osmotic pressure decreases), this "extra" liquid goes to the tissues, primarily to the brain tissue. And if a healthy person in response to a decrease in the level of glucose compensates for the production of more hormones-insulin antagonists aimed at the release of the necessary glucose from its depot in the liver, then in diabetics this regulation is disrupted.

In addition, in diabetes mellitus, not only "simple" insulin is prescribed, but also prolonged, having a long-term effect. In case of an overdose or some actions that lead to a decrease in blood sugar concentration, a hypoglycemic condition can occur in a dream, not be recognized in a timely manner, and grow into a coma.

Why is a hypoglycemic coma? Emergency and Symptoms

Not only diabetes is the cause of hypoglycemia, however - this is the most common situation. In other cases, a person can feel the initial manifestations of lowering the sugar level and take measures (eat), in the case of a long "experience" of the disease this may not happen, and it will come to a coma. It coma occurs when the glucose level drops below 2.5 mmol / liter (the lower limit of the norm is 3.3 mmol / liter, for many diabetics the "usual level" is 7-8 mmol / liter, and everything below it is already Causes feelings of hypoglycemia).

In a diabetic patient, a hypoglycemic coma may occur due to:

• An overdose of insulin is intentional or unintentional;
• An overdose of a tabletted hypoglycemic agent;
• Fasting or taking a small amount of food 30-40 minutes after the injection of insulin;
• When a person entered a previously calculated dose, but before that he had an increased physical load;
• When the schedule of injections of insulin is violated. Here it must be said that a person suffering from diabetes, if he got into a hospital, should not make insulin "as before" without determining the glycemic profile: a more or less serious disease "breaks compensation", and insulin doses should be determined every day, After the attending physician recognizes the level of sugar in the blood;
• After drinking alcohol: ethyl alcohol reduces the activity of those enzymes that are responsible for producing additional, if necessary, glucose. That is, alcohol "blocks the road" to protective mechanisms.

Other causes of hypoglycemia:

• Prolonged fasting, especially when the person is physically hard at work;
• Deliberate introduction of insulin by a healthy person to himself or another person;
• Pancreatic necrosis, acute pancreatitis and hepatitis;
• The presence in the body of a tumor that produces insulin.

Before the development of a coma directly for some time (up to several hours), there may be symptoms:

• Inadequacy of behavior (more often - aggression);
• Weakness, fatigue;
• Trembling of hands;
• Trembling all over the body;
• A feeling of severe hunger.

In this case, most often a person covers a cold sticky sweat, he becomes pale, his quick pulse is probed. Further, a person can calm down, lie down to rest, and from the side it is noticeable that the release of cold sweat continues , and a restless sleep, a person often screams, expresses crazy wishes. If you try to wake him, he can react at first, but usually - without opening his eyes and not recognizing others. This is a starting hypoglycemic coma. Emergency care should be provided right now.

Therefore, if you notice inadequacy, aggressiveness and disorientation in a person who suffers from diabetes (even if he periodically responds that he is all right), but you do not have a glucose meter at hand, help as in a hypoglycemic state: a lot of sugar in the blood It does not represent such a danger to life as a state when it is not enough. It is during hypoglycemic state (coma) that the account goes for minutes, whereas a coma caused by a high sugar level is unlikely to lead to death and disability if assistance is provided in 30-40 minutes.

Help with hypoglycemic coma

It is an intravenous solution of glucose . It is best if the house has a glucometer. If you know the technique of intravenous injections, then if you have signs of hypoglycemia, you can inject undiluted 40% glucose in an amount of 20-40 ml. Then do not leave the vein. Intramuscularly, you can prick (if any) glucagon.

Let someone else call an ambulance (hospitalization is needed, especially if there was an overdose of prolonged insulin).

If consciousness is not restored, make another 20 ml of the same glucose, enter 1 ampoule of "Prednisolone" or "Dexamethasone" intravenously, diluting it in 10 ml of isotonic sodium chloride. If this is done without controlling the glucose level of the glucometer, do nothing more before arriving at the ambulance.

First aid for hypoglycemic coma, in the event that relatives do not know the technique of intravenous injections, and there is no glucagon in the house (this is an expensive drug) is as follows:

• Put the patient on his side, watching the breath, so that it does not stop;
• Open the window, window, so that more oxygen comes;
• If possible under the tongue put a couple of small (one) slices of refined sugar, while making sure that this sugar was not swallowed, since the patient in the unconscious state can, by moving the jaws, block such a piece of his respiratory tract.

To drink to a sick person in a coma can not be given: since you will only pour this liquid into the lungs, then it will be very difficult and sometimes impossible to cure such consequences.

If you managed to catch a man while he was still conscious, but inadequate and excited, try to give him sweet soda water, warm water with sugar or honey, just a sweet or a spoonful of honey. An ambulance is mandatory, even if you have yourself coped with this dangerous condition by such carbohydrates.