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Scenario: Fall with Diabetes


Please note: The users who submit scenarios have declared that all patient details are fiction. We cannot guarentee the accuracy of any suggested treatment or the realism of suggested observations. You should judge these for yourself.



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Scenario Overview:
You are first aiding at a sports venue where a large variety of sports are in progress. You are walking around the event and come across a patient sitting on the floor, holding their arm in evident pain and not entirely with it. The patient has diabetes and has low blood sugar levels (hypoglycaemia) and has consequently collapsed, injuring their arm on the way down.
Difficulty:
First Aider Easy
How the scenario should progress:
If the first aiders treat the low blood sugars level, then the patient will become more orientated and feel better (alhough still have an injured arm!). If the first aiders do not treat for low blood sugar levels, the patient will become more confused and will eventually become unresponsive.
Patient 1:
Name: Hattie Hart    Age: 23    Sex: Female
Medication: Insulin
Allergies: Shellfish
Past medical/family/social history: Patient has type 1 diabetes.
Findings on examination: Pain in lower arm, lots of bruising and perhaps some minor deformity (depending on how mean you are feeling). The patient is in pain and concerned about their arm but is a bit confused and not totally orientated to place and time. The patient last ate the night before and had just played in a football match this morning.
Possible treatment from first aiders: Take a thorough history of the events leading up to the collapse. Treat for low blood sugars. Examine the arm and make appropriate treatment.
Time after start: 0mins If low sugars treated If low sugars not treated
Response: Alert but confused Alert Moving towards Unresponsive
Airway: Clear Clear Clear
Breathing? Yes Yes Yes
Respirations: 22 18 23
Pulse: 130 105 138
Blood Glucose: 2.1 mmol/l 4.2 mmol/l 2.1 mmol/l



Tips for the patient actors:
Try to draw attention to the arm whilst also acting confused. The arm injury is meant to be a bit of a red herring that the first aiders should dig into further to find out why you fell over. If asked if you tripped. answer that you don't think so and that you're not really sure why you fell over. If asked if you have any medical conditions then tell them about your diabetes. You might want to be a bit irritable whilst having the low sugars.

Scenario submitted by: Anonymous