First of all, thank you for your service. Secondly, I am a diabetic but I dont like wearing bracelets or necklaces, etc. that could let emergency responders know that I am a diabetic. Considering maybe a small tattoo instead. Is this a thing? Have you seen it before? What should it be and where should I put it. Thanks again.
I mean depending on the situation they might actually be sweating it out….
If you cannot tell me you’re a diabetic I’ll find out fairly quickly when I check your blood sugar.
This guy does EMS. It's definitely not something to worry about op. Even if you can't tell us and there's no one around that knows your history checking blood sugar will be one of the first things any EMS department does for someone with altered mental status or who is an unconscious unknown.
As someone said, well find out you're blood sugars are the problem in our initial assessment. But if you insist on a tattoo, I'd would think the wrist would be the best place.
Thanks...is not that I want a tattoo I just thought it might help but the general feeling seems to be that its unnescessary.
It's completely unnecessary. Blood sugar gets checked on a majority of patients normally. If you're altered or unresponsive, it'll be one of the first things checked.
Were supposed to get sugars on all them? No wonder QIC has been sending me all those emails. I guess I better read them
Eh might be a good idea lol
I always thought we just narcaned everyone that we found all geetered out. That's what the police do and look at how much luck they have! There's gotta be somthing to it
Only works if you give 8mg though
I like where your heads at champ. 12mg or nothing though for me
Also need to do cpr on people that are sleeping ☺️ And don’t stop even if they start yelling “Ow! That hurts!” that just means you have effective compression
Memaw in bed- "WhAt ArE you DoInG!! PlEaSe StOp!!"
Me with fat pinch of skoal in my mouth still-" MAAM IM TRYING TO SAVE YOUR LIFE! REMAIN CALM AND LET ME SAVE YOU!
BGL should always be taken for ALOC (now you can ignore your email inbox lol)
Thank you! You're a Saint!
No one's gonna go looking for a diabetic tattoo, nor diabetic jewelry...
I see a guy w altered mentation, I check a blood sugar... it's a standard of care
Ok, thanks. My wife bought me one of those necklaces but I cant stand to wear that stuff. She worries...
In my state, glucometer use is not standing order. EMTs have to have medical director approval and additional training to use a glucometer. Glucagon is also an additional option with the appropriate clearance and training.
What state is that? That seems to be a weird thing to have as a medical director approval.
I have been out of EMS for almost 9 years, but when I was working as an EMTB, we were not allowed to finger prick a pt. That was considered an advanced procedure. Oral glucagon was permitted if either the pt or family member did it, and we visually saw the reading. Luckily, that has changed since our state now has EMTA.
my county only in the last year started letting basics use the glucometer. we could give oral glucose but not check the sugar.
Massachusetts
Strange, because the protocols for Massachusetts have EMTs obtaining glucose without calling for medical direction.
Wow. In MD it's pretty much added to ABC.
I work in MA and I have NEVER heard this. I just looked through the Medical Director options, Glucometer is not in there, Glucagon is.
It looks like they may have revised the protocols, and blood glucose analysis is in everyone’s scope. I looked back at the protocols from when I started in 2019 here, if you scroll down to scope of practice blood glucose analysis is listed as conditional. So as recently as 5 years ago not all EMTs were allowed to use a glucometer.
Then they changed it before I got my EMT in 2020
This is literally why we should have one single governing body dictate EMS education and protocols. This is one of the least invasive things we can do to assess patients with an altered level of consciousness.
You’re downvoted but it’s state-by-state. In New Jersey I can’t check blood sugar as an EMT
I'm completely blown away by this. A glucometer can be purchased OTC at a pharmacy and literally used by anyone. How is this even a thing?!??!
Untrained bystanders and family members can obtain BGLs all day long!
Do you need orders for temperatures too?
ETA: same for oral glucose. It's OTC and can be given by untrained bystanders and family members. We order ours on Amazon. Small rural service here. Cheaper on Prime than an hour ride to "town."
Might wanna check your sources bro.
It appears they’ve updated the protocols in the last couple years, but when I started in EMS in 2019 this was the case, and here are the 2019 protocols to prove it. Im not sure what year they made the change, but it was recent.
Ok, then will the Tx change if OP is wearing a necklace?
I'd assume you're calling for ALS then?
I dont get the downvotes, its kinda similar for me here
If you’re altered and we see a diabetic tattoo/bracelet/whatever, we will check a blood sugar. If you’re altered and you don’t have a tattoo/bracelet/whatever, we’ll still check a blood sugar. It makes zero difference to us. Please only get a tattoo if it’s something you actually want on your body
No...I dont really want one. Dont have any. I guess these days that would make me the unique one...lol.
I'm checking your sugar way before I'm reading your tattoos. unless you get it on your face, I probably won't notice it. but if you're not alert, I will be checking your sugar. I think that's pretty universal.
If youre not in the state to be able to tell us youre a diabetic, were gonna find out after we check your sugar
Big bold times new Roman's font on your forehead. It's the only way
Ok thanks. I had a seizure once and was completely out of it for a bit. I had been driving on the highway 10 minutes earlier..scared the shit outta me...I let my blood sugar get way too low. But, now I know how to manage it. Wont let that happen again, hopefully.
Do you live in an urban or rural area? How close to a hospital are you?
Would you be opposed to a small sticker on the lower front windshield of your car that indicates so?
If you were to get into an accident due to blood sugar issues, very possible that a blood sugar will be low on the priority list or ommitted completely.
Perhaps a small patch you can add to the arm of your shirts.
I’m checking blood sugar before I’m checking tattoos. Especially if the pt can’t talk to me.
Everyone already hit that we'll catch it pretty quick with blood sugar since we do that pretty regularly, especially if you have altered mental status, but forearm/wrist tattoo would be pretty noticeable, especially since many people who have medical IDs wear them around their wrists.
Thanks.
I don’t go looking for tattoos as part of my evaluation. The first thing I will check for someone who is confused is their blood sugar that takes 5 seconds and is not invasive.
I had a patient who had tatted diabeetus with bunch of sweets on his left forearm. RBS asap. It was one of the fun shifts.
For me as a Basic in rural NY my protocols are that if there is ever any altered mental status that we are required to check BGL, so either you would tell me you are a diabetic or my glucometer will
Edit: Have to point out that being allowed to take a BGL in NY requires special lab licensing for the agency and that the provider (at least at the Basic level) have completed the BGL regional skill evaluation that year.
What? I was an emt-b in upstate in the finger lakes region and never had to do any special testing to take a bg it was standard for pretty much any altered patient and was a standard part of my emt-b training
Are you talking about skills sign offs? Because that applies to p much every skill
Well with my agency our region is managed by Fort Drum Regional Health and I'm in the north country and the skills sign off at least in my area is called regional skills which is for BGL, nebulizers, AEDs, stick & inject, CPAP, and probably forgetting one or two. And the reason why it is technically separate is due to it not being apart of the NREMT so they have it as separate so that NREMTs can join get license and then do that to be able to run with agencies otherwise they would not be able to join (or at least be much harder) agencies due to how certifications work.
Yeah I think that's normal for every agency, we all have to do regional and nremt sign offs
I wouldn't miss it on the forehead.
A tattoo somewhere that's not often covered, like hand or neck. If you're coming off drunk or otherwise impaired, it may be the cops who see you first, and you'd want any indication possible that this could be a medical issue.
don’t worry about it, I’ll just check your blood sugar
I would say having something that identifies you as a diabetic would be a good idea. EMS will figure it out pretty quickly that you’re having a sugar problem, either high or low…..however PD is another story. If someone is slow to respond PD is going to narcan it, and if someone is agitated they’re going to see it as aggressive and potentially use excessive (for your case) force and not realize that you aren’t being a dick your sugar is just off. I would think that by having an identifier they would call in medical sooner so we can fix/help the problem
yeahh first things we do is check the blood sugar so i think you’ll be chillen dawg
I have a friend who has a large tattoo on his arm. It’s a caduceus that has “Diabetic” in the middle and one of the snakes continues around his arm and down his side to his port. It looks pretty neat
Tbh - If you’re down for it, a tattoo (or other indicator) can be a good idea for two reasons.
1) None of us are perfect. Plenty of paramedics, nurses, and doctors have missed hypo/hyperglycemia because they thought the patient was drunk/high/psychiatric, etc. We should catch this on a routine exam, but complacency exists.
2) In the rare case you have an episode in an atypical environment like a plane, or with law enforcement- that may help these lay people take care of you. It could be the difference between a medic pulling you out of a car or a jail cell (I think many of us have ran both of these calls). Flight attendants also get limited first aid training, and on commercial flights - they won’t have a glucometer, but will have both oral and IV sugar.
(Incidentally, I know 3 medics and 4 nurses who are now flight attendants - they have a unique perspective on in-flight medical emergencies)
I also have two friends that have diabetes tattoos - both on their forearms. Hasn’t been necessary for either, but they feel better about it. Forearms (especially the left) we will often expose for IV access. We’re more likely to find that tattoo than something on your back, ankle, or shoulder.
Thanks. Is the tattoo some kind of symbol or just the word "diabetic"?
One looks like a medical alert bracelet just tattooed on. The other is a star of life (EMS Symbol) with Diabetic written through the middle
Thank you.
If you're not able to tell us you're diabetic sugar is going to be literally one of the first things we check. Honestly I'd probably get a sugar before investigating medical alert bracelets and certainly before finding a tattoo on someone who was unresponsive or minimally responsive.
Haha narcan goess brrrt…
I think you're looking for the police subreddit. We don't narcan diabetic emergencies here.
I know…
Don’t thank these goons, it’s like feeding animals at the zoo. Also, I have never seen a medical alert tattoo before. Not saying it’s the worst idea ever, just never seen one before.
Personally I will probably not notice the tattoo, if you’re acting funny or abnormal or are unresponsive( and a few other presentations ) I’m just gonna check a blood sugar as should any good provider. I think if you really are worried maybe a small business like card in your wallet might help incase Pd arrive first and are looking to Help ID who you are.
Interesting. I was curious as to whether or not medical "tattoos" were even a thing and if they were, was there a preferred location that first responders would be trained to look for. Particularly maybe police officers who may get there first but might no have any real medical training. If I was having a diabetic episode, could it be confused as a drug overdose? Could I be injected with Narcan? I understand that in and of itsself wont do any harm but it could happen, right?
Medical tattoos are a thing, but we don't always see them, and they're more for conditions we wouldn't catch with a basic assessment.
The police wouldn't give you IV narcan, most likely. It would be intranasal spray, and no, it wouldn't have any effect on you unless you had opiates in your system. But carrying some kind of notifier in case police are first to arrive isn't a bad idea, though I don't think they're likely to see a tattoo until EMS gets there anyway. A card in your wallet, something on your car window (that doesn't obstruct view— check local laws on that), or something similar wouldn't be a bad idea.
Something like this could help. Thinking about getting one myself. It's small enough you could wear it like a necklace, or put it on your keys m
KEKHEALTH 2PCS QR Medical Alert ID Tag Life Alert Keychain Epipen Alert Pendant,Medical Alert ID for Women,QR Online Profile for Medical Conditions Emergency Contacts https://a.co/d/bcM6kYj
If we don't know that your sugars are out within about 3 minutes, we have failed epically
Most of the times someone is having a diabetic emergency they know, or are altered and the first thing I get is a blood sugar. So hypothetically if you had an emergency and were not acting right I would immediately get a blood sugar.
That being said tho, I’ve actually met a few ppl who had all their medical information in their phone and that was super helpful. But ofc this isn’t always accessible if you’re unconscious or something
Thanks everyone. Question answered.
Dexcom is usually a giveaway
I would pretty quickly pick up on the fact that you're hypoglycemic based on your presentation when we find you.
Diabetic issues are very common in EMS. It couldn't hurt. My instructor went on a call with a pt who had their Living Will tattooed on their back (according to med direction and legal, it was legit), medical alert tattoos are becoming more common, and advanced directives are even starting to creep in, but if you're in distress, there's a good chance EMS would figure out that it's a diabetic emergency pretty quick.
If you have an iPhone you can create a medical ID that we can check and you can add you medications, emergency contact, and medical conditions into it. Never actually seen someone have their set up but u have mine setup.
One of my friends has a Disney themed diabetic tattoo on her wrist, suppose you it’s the logic if they are looking for a medical alert bracelets you’ll see it. You could always set up medical alert on your phone - but can’t say I’ve always checked this as a first priority when on scene
Full assessment includes a bgl anyway. So without any alert, if the crew does their job, your bgl will be checked regardless.
Something small, visible, and on a pulse point. Maybe the inside of the wrist?
I test a blood glucose for every sick person call. I've had people tell me they aren't diabetic, yet when I test, it says "hi" on the glucometer. If they send a BLS crew (which let's face it a lot of places still do) they may or may not catch it. I've seen BLS crews get sent to the nursing home for abnormal labs, patient is completely altered and it turns out it's glucose related, but the newbie crew misses it because the nurse tells them it's abnormal labs.
So, out in public, if something happens, you may get some bystander that thinks you're having a heart attack and they hurt you by doing CPR when it's not needed. If you want the peace of mind protecting you from that, a tattoo may be an option for you.
Thank you...
If you’re altered they finna check a sugar regardless if you have a tat saying “defs not a diabetic” -so no, but if u want 1 cause it’s cute or whatever, yolo
Paramedic here from Australia, where we have a patient who is not responsive, we undertake a complete assessment and eliminate all probable causes.
So, as a Paramedic, we do a primary survey, make sure a patients cardio respiratory system is clear and functioning.
Thereafter, we do a systematic approach, I use AEIOU TIPS
Alcohol Epilepsy Insulin < this is for diabetes Overdose Urea
Trauma Infection Perturity/Poisoning Sepsis/Stroke
So regardless of every patient with or without prompts we undertake a methodical approach.
Thank you
Iʻve had several patients who are non diabetic after 5-10 years of changing their diet.
I am type 2. Had a seizure once years ago but I manage it better know with diet and a few medications. No insilin.
Sorry, see posts above. Tried to respond to you but I messed itnup.
So one of my patients with grandl mal seizures in his 20ʻs, did a ton of research (his parents were very well off) he found out that his seizures derived from exposure to the lighting fixtures, his case flourescent tubes, from birth. He was never exposed to natural lighting at night (moon, stars, lights off) and had grew up in The Bronx. About 4 years later his seizures became less frequent, to about 3 per year. Still grand mal but he was having like 14/week that werenʻt as intense but his medication and doagnosis prevented him from driving. He is now a forklift operator, living his best life. Something about the photonic and oxygenic circulation in a personʻs system. Pigment and certain things like chlorophyll, beta carotene, deficiencies were likely the cause. A good multivitamin is always a good way to make sure you get the micro/macro minerals and compounds a healthy body needs to function. Just tattooing your body should be some sort of form of artistic expression that your really into. If you want a medical alert thing put a sticker on the back of your license or something.
Oh and melatonin supplementation at night but nothing more than 3mg. Is always a good way to stabilize that sleep/wake rhythm. But melatonin is actually found in the body and only generated when the sun goes down so its kind of like taking it only when the sun has set is crucial to its success. 10mgs is waaay a lot and 5mgs is still sort of a bunch. 1mg/3mg is a good way to start. You should ask your doctor about adding in melatonin to your night meds.
In my service we check glucose as a standard for almost everything. It's becoming part of vitals at this point.
It's not exactly a bad thing to have, but honestly diabetic issues are one of the single most common things we run into on a daily basis. This isn't something that should be missed even by an absolute rookie.
Don't sweat it unless you just think it would bring you peace of mind.