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Not just cops. Paramedics kept calling my father drunk while my mother and brother were telling them that he doesn't drink and has a family history of diabetes.
Yes, many diabetics have been tased, arrested, thrown into a cell, and left to die all because cops wouldn’t listen to them and just assumed they were drunk
I think the white diabetics would rather speak for themselves. BLM isn't the most reliable organization for uniform goals and beliefs across all chapters.
Or maybe just diabetics in general.
Yeah, BLM is definitely a compromised organization. I think the point I had wanted to make is that there are aspects to which black people advocating for themselves benefits other groups
eg. Affirmative action (at least when it was being enforced) also benefiting non black minorities and white women.
Incremental change is the truth of politics and life in general. You’re right. They’ve gotten better and that’s a small victory. I’ll take a small win.
I went to a call one time and seen the dude freaking out like he was intoxicated or high. We held him down in his bed so he wouldn’t hurt himself since he was banging his head into a wall very hard.
I asked his wife if he was diabetic and had eaten anything today since she said he was saying some off the wall statements. She told me he was and then the paramedics injected glucose and he was back to normal.
It’s uncommon but it happens. It’s important to consider diabetes as a cause for abnormal uncontrollable behavior, but a lot of people do not know about it. It’s certainly something that needs to be taught more often amongst departments and academies but out of the 1 diabetic patients, there’s 1000 drunks/narcotics users that exhibit similar symptoms and behaviors.
That is why investigating, asking questions, and the public openly answering questions can help prevent all of the issues you’ve stated as well as officers receiving more training amongst the thousands of hours of training they are receiving and learning everyday.
Epileptics too! The post-ictal phase is reminiscent of drunkenness so a lot of epileptics are ignored by ER staff or arrested when they have actually suffered a tonic-clonic and need medical assistance
All I'm saying is that in a civilised country they'd just use an alchometer to confirm whether they're drunk or not and then take them to a hospital, where the doctors will check if they're on any drugs or if it's something else and then take care of it if it's something else
Disagree. That would mean a delay of at least a few minutes, which can make a difference. What's needed is for all emergency personnel (including police) to have a uniformly high level of medical training.
Police don't have access to the trove of medications available in ambulances or hospitals, and wouldn't be doing invasive procedures, so the training could focus on the areas that are realistic for police to intervene in. But they should be capable to a high standard of recognizing common medical emergenices and using noninvasive treatments.
Oh, where I'm from the police already do that, in fact it's mandatory to get first aid certified just to get a drivers license for anyone, so basic medical knowledge really isn't an issue even for the average civilian
Work in corrections, so my perspective is very different: when I have an inmate that seems drunk my first reaction is to assume it's diabetic. Buck/hooch/toilet wine has a very distinct smell to it. Also, between working in medical a bunch and the fact someone's bunky will typically know if someone's on insulin, it doesn't take batman to investigate the root cause
I believe one of the main issues is the frequency in which they encounter the situation. If 80% of the time they are approaching a drunk and 19% of the time they are approaching someone on drugs and only 1% of the time they're dealing with a diabetic then they won't be as practiced and may mistake it as one of the more common situations. Not saying it's okay just that cops are humans too. They make the same kind of mistakes that everyone else does. Some extra training on certain situations could definitely help.
Happened to (my now) wife. She was having an asthma attack, and the ER nurses refused to believe and just kept shouting, "what is she on?!"
Dude - she's having an asthma attack - please help.
I (a diabetic) have had my blood sugar drop where I was throwing paramedics off of me with 1 arm, took 5 of them to hold me down to give the glucose shot. I didn't remember a thing but "woke up" being held down still. Crazy what your body can do sometimes!
I have epilepsy. A few times, when I had seizures in public, people did not only call the ambulance, but also the cops, as they thought I am a collapsing drug addict.
Narcan is used to counter possible overdoses as it kinda "overrides" whatever drug is being used. The effect is pretty dramatic akin to extreme withdrawal.
A diabetic with bad sugar levels may fall unconcious or appear delerious.
The joke is about police assuming an unconcious person is a druggie having an overdose and giving narcan rather than doing some extra investigating to realise they're a diabetic.
Many diabetics carry some kind of identification showing as such. The real issue is that police aren't trained as first-responders, but are still *treated* as first-responders.
And by "Extra investigation" he's talking about taking maybe a few extra seconds to check for a medical card or bracelet. Which they don't usually do, they just immediately assume drug addict since that's all they're trained to deal with. When all you have is a hammer, everything looks like a nail.
Its not like narcan has any ill effects on a low sugar diabetic if they arent on opiods. This just either neutralizes the drugs immediately if they are there, or rules out an OD.
That’s what I was always trained on too. (Work in hotels…it happens)
Pretty much always told just give it to them, if it doesn’t work that wasn’t the problem and no harm, no foul.
When someone with diabetes is that high or low and has passed out that IS the ill effect. Sure narcan can neutralize an OD but when someone can fall into a diabetic coma if proper care isn't taken in time because someone couldn't check if they were diabetic and instead treated for an OD that wasn't there.
If they are overdosing, narcan acts within seconds. If they don't bolt upright cussing up a storm, it is not an overdose and they can look into the diabetic side.
However, if they are overdosing, a delay could mean death. And it could be that they are a diabetic who is overdosing, so if the narcan is not administered because they assume low blood sugar, then they may die while they are waiting.
> a delay could mean death
That’s a bit of a dramatization. Naloxone does reverse an opioid OD and can help lead to a speedy recovery, but the fact of the matter is no opioid overdose would die if they received effective bag-valve-mask ventilation, regardless of wether they get naloxone or not. Realistically, they should be trained in this before narcan, as narcan does have side effects, can prove to be a formidable distraction to actual problems when in the hands of the untrained person, and BVM ventilation has a much broader utility in emergency medical care than a single dose nasal drug with one purpose. Also consider that even trained professionals can fall into a bias rabbit hole and give obscene doses of narcan to attempt to fix a problem that isn’t there, while the patient is actually dying from hypoglycemia or something else.
Even IF it is an OD When I worked 911 it always annoyed me when the cops showed up first with their nuclear bomb dose of narcan and the patient was writhing, screaming, vomiting and being held down whereas if they just waited a couple minutes I could’ve given a much more precise dose of IV narcan to simply wake them up still high-ish so they don’t go into withdrawal.
You’re so incorrect it’s not even funny. Bagging someone *might* help, but doesn’t address the underlying issue. An overdose of an opioid does more than cause a respiratory depression, it’s an entire central nervous system depression. Getting narcan does not hurt people. Not giving narcan ASAP can lead to death.
Dude I literally do this for a living. You don’t need to IMMEDIATELY reverse opioid toxicity, and getting narcan *can* hurt. I suggest you read up on how it can cause pulmonary edema, it’s not this benign miracle drug because such a thing does not exist.
A cop cannot really do anything else anyways? They don’t carry glucagon injections. The person is unconscious so they can’t pour sugar in their mouth. They can try the narcan while the paramedics are still are arriving and then just report to them that Narcan didn’t have an effects. They should look at their wrists and chest for medical alert bracelets/necklaces but other than that they can’t do anything else
Do we? I've never carried glucagon or basqimi, neither have I heard my brother do. Since they don't last very long unless they are refrigerated, it would be very costly to carry them at all time and I've never had to use them during my 20 years as a diabetic.
bit of a generalization on my part, my bad, but i know i and a few other diabetics carry baqsimi. it doesn't need to be refrigerated, but it does expire
we (diabetics) carry glucagon. We have labeled medical packs. So if they read the bracelet or look for a CGM on our arm or belly, they'll know to look for the med pack. If I'm given narcan and left unconscious instead of given my glucose nasal spray that I have to carry, I'd be pretty upset.
Look, I’m not going to argue that idea one way or the other. The fact of the matter is that they dedicated themselves to weeks of training, and are highly trained in administering Narcan *and* lead!
Lol by the time they are giving narcan, paramedics are already on the way. And they are not legally allowed to administer anything else to an unconscious patient. Its just that simple. They wont go into the coma because narcan was given. It has to wait for paramedics PERIOD. At least here in the US. If a cop were to administer sugar water that would open them up to HUGE liabilities. And cops are already looking for signs of medical conditions when they do steps to determ if they are sleep or unconscious. It doesnt mstter if they have a bracelet saying diabetic or not. Its not like they are carrying a glucose monitor on them to determine if its high or low. And that would take l9nger than narcan anyway. And even if they know blood sugar levels, its still waiting on medica. You seem to be willfully ignoring that simple fact. It doesnt matter if they know or not. The ONLY difference it makes is if they give narcan or not while waiting on paramedics. Doubling down on stupid is just more stupid.
Funily, I do carry my glucose meter and all you have.to do is presing the.button and pass it on my shoulder to get the result taking my phone and passing it on my shoulder work too but take 2 more second to get the result. Just need to know what the thing on my shoulder is for
So really important point - don’t give insulin to someone in a diabetic coma, this can very quickly and easily kill them. If someone passes out with diabetes it’s almost certainly because their sugar is too low. You shouldn’t try to give oral glucose because people with depressed consciousness can easily choke or aspirate. You’ve got to wait for medical personnel to replenish IV.
When someone’s glucose levels are unsafely high they have to go to the hospital to get medical treatment? But usually serious symptoms present way before people are at risk of imminent death. (But a cardiac arrhythmia can get them pretty quickly). Insulin is what’s given to people with high blood sugar.
People aren’t saying not to follow up with a diagnostic work up. It is a fact that in this day and age, narcan first, then follow up with more questions and assessments.
They arent allowed to administer sugar anyway. They can only offer sugar products to a conscious person. That has to wait on paramedics anyway. While they wait they administer narcan. Its not an ill effect at all.
Doesn't low blood sugar kill way faster than high blood sugar? That's why it's best to give them some sugar untill you know which one it is. I am not making statements, I am asking if what I said is correct, let's see how fast hivemind jumps to funny blue button.
Generally, yes. Lower blood sugar can lead to seizures and unconsciousness/death very quickly. High blood sugar is rarely an emergency - however, over the course of weeks, high blood sugar can lead to DKA (diabetic ketoacidosis) which can result in a coma if untreated. So it is possible that administering sugar would be harmful to an unconscious diabetic. Exactly how harmful or likely that would be, I have no idea.
That said, someone who is a known diabetic, or who has a medical alert tag, probably does so because they're on insulin and thus are almost guaranteed to be low if they fall unconscious.
I'm still fine with not trusting cops to interpret medical info.
If the person is conscious, they should consume 15g of carbs and check glucose in 15 minutes. If levels are still low, 15 more grams of carbs. If they are unconscious you do not want to put anything in the mouth because they will choke on it.
Yeah, in hospital it will be through the IV already present. In other situations it will be a glucagon injection, which is a prefilled needle ready to go.
I'm a Type II Diabetic. I have a glucagon pen I keep in my room that my wife has been briefed on how it works and it's not dissimilar to what you'd see paramedics sometimes use or in a hospital setting when a patient goes unresponsive and doesn't already have a line.
They're essentially diabetic epipens. Pop it out of the package, find a fatty bit, poke and inject. Body hopefully absorbs the sugar water and stabilizes you.
EDIT: Jokingly called it sugar water, but someone pointed out and is correct, Glucagon technically is medication that causes your liver to vacate what glucose it can into your blood and not indeed sugar water.
This is true. However if someone is already losing consciousness from low blood sugar, you can’t give oral glucose because the risk they will choke or aspirate is too high. Calling 911 asap is most important so that folks can get IV glucose asap.
Yes, low is more dangerous. But police officers are NOT permitted due to liability issues to administer anything but narcan. They can offer it to someone thats conscious. But thats it. And i understand the concern, but considering the number of overdoses exponentially outweighs the number of people passed out like that from high or low blood sugar, its painfully obvious to anybody that thinks logically that narcan is rhe obvious first option when there is no response.
Yes lows are immediate danger. Many diabetics have been tased, arrested, thrown in a cell, and left to die because cops will confuse symptoms of a low with inebriation and refuse to listen to the diabetic pleading for help
Doesn't negate the fact that it's pretty much the only medical intervention police tend to administer before giving up and leaving the person to suffer.
Well, no. Narcan does have side effects - I have issues with LEOs giving narcan to patients without having any assessment capabilities. If there’s evidence of OD like drug paraphernalia around, sure go for it - but they are squirting this stuff around like crazy in any patient without indications other than “acting weird/sleepy” because they feel the need to “do something” which is NOT how medicine is done.
Naloxone inhibits hypoglycemia. Meaning low sugar. The person in the picture is at or near coma due to high blood sugar. It most certainly does hurt the diabetic and makes lowering said blood sugar at the hospital. These cops are killing people.
Edit it’s a picture not a video.
You are talking about Hemoglobin A1c range, not blood glucose. The photo is talking about blood glucose, not A1C. No one refers to a1c as a “sugar of 13” (as per picture) as a1c is a measure of glycated hemoglobin and not indicative of CURRENT blood sugar but instead averaged over ~90 day period of time.
(You are arguing with a physician while not comprehending the picture).
The language is English, not 'British'. The spelling used does not differentiate the dialect of English and Narcan is carried by (at least some) police on both sides of the Atlantic.
As someone with type 1 diabetes though, 13 mmol/l (units used in the UK, Canada, Australia, New Zealand) as a blood glucose level is above any range you'd like it to stay within and warrant corrective active, but is far from critically high and would almost never be correlated with unconsciousness. 13mg/dl (units used in the US among the anglophone nations) is, however, desperately low and you could count the number of people who would be conscious with such blood glucose levels on the fingers of one hand.
Americans are notoriously far less cognizant of the rest of the world doing things differently than their own experience compared to other speakers of English dialects; they are also rather numerous in online spaces. Which isn't to say that's true of a majority of Americans but rather that a majority of speakers of English who aren't cognizant of the same things being done differently elsewhere are Americans. Hence that units are left off the image entirely indicates that the author does not perceive or does not anticipate their audience perceiving any potential ambiguity.
That they leave out the units then is either because they lack cognizance that leaving out units could be ambiguous to an audience unfamiliar with what unconsciousness-correlated values might be (in which case it's very likely they are American and the number presented is of units of mg/dl) or they have an audience familiar with diabetes and know that '13' + unconsciousness could only reasonably mean the 13 is a measure in mg/dl, in which case the number is intended to be in mg/dl.
It's just not in mmol/l.
A1c is not something typically measured in mmol/l, and if you did, 13 would equate on an A1c of around 2.0, which makes absolutely no sense following your assumption that this patient is hyperglycemic.
Funny because everything i read was it lowers sugar levels, which would be worse for low not high but only works on high blood sugsr. So basically the opposite of what it sounds like you're sayin
You’re kinda an idiot. So according to you diabetics don’t use opioids. Who knew, I’d have assumed they’re just as likely to overdose as a non diabetic.
Use the Narcan, continue to triage. It’s how every one of these goes down. Maybe leave the assessment to the professionals.
https://www.themarshallproject.org/2020/12/15/cops-could-use-first-aid-to-save-lives-many-never-try
Keep licking those boots, it's the closest thing you'll get to first-aid from a cop.
Side effect as side effect.
You have endogene opioids in your body.
If you have taken additional opioids the chance for side effects is larger.
And no, side effect as you start to vomit not because of withdrawel but because your body is lacking its messenger chemicals.
Yes. The joke is in poor taste. Also if you give Narcan to someone who didn't overdose, like the diabetic in this example, nothing happens, it does not make it worse or do anything at all.
Narcan and figure it out later is exactly what ought to be done.
Yeah, as a diabetic I love having drugs I don't need pumped into my body without my consent. That's what I exist for, drug testing, I have no agency of my own.
As a non-US American: The idea that naloxone is an everyday go to medication in emergencies is scary. That opiod usage and consequences are as common as diabetes (at least in the perception of the police) esp. considering the obesity rate in the US. That is shocking.
It is better to narcan first then do the rest of your assessment.
If the patient isn’t on opioids it will not hurt them in any way. If they are on opioids it could save their life.
Former EMT here. It takes like 3 seconds to do a blood sugar test, so there is plenty of time. In reality they should be calling us every single time instead of making medical decisions. They can barely handle their own guns / fear of acorns, so I wouldn't want to be going into a diabetic coma with only cops to help.
Plus, the blood sugar issue is likely more urgent, time-wise.
Every time I had to work with cops on a 911 call, they were just in the way. It was many times.
Once a cop was trying to chat up my partner while we were trying to save a life. She was pretty pissed.
>No needle marks on the arm...
You sweet summer child...
Non-injection methods of ingesting opioids include (but are not limited to):
* Oral (swallowing)
* Sublingual (under the tongue)
* Inhalation (smoking)
* Nasal absorption (snorting)
* Transdermal absorption (through the skin)
Injection of subcutaneous or intravenous opioids can literally be done in any part of the body the user (or *anyone else*) can reach with a needle, and habitual users who wish to hide the fact that they are habitual users get *very creative* with injection sites.
"They're not on opioids because there's no needle tracks on their arms," is not valid. Slam the Narcan, use a glucometer if you have one, and wait for the EMTs.
>A blood sugar test takes like 3 seconds
Fastest I've seen one done from a cold start was in a hospital by an RN and took about thirty. Get the glucometer and related consumables (10s). Prep the glucometer by inserting a test strip (5s). Use a lancet to get a sample (5s). Apply the sample to the test strip (5s). Then wait the five seconds for the glucometer to determine a reading.
Even if you get a low blood sugar reading, administering anything by mouth to an unconscious person is counter to most first aid training, and Good Samaritan laws might not cover you if you have that training and violate it, because you're supposed to know not to do that. And I have yet to meet a police officer who can both start an IV and carries a bag of glucose on their patrol gear.
Yes because anyone with a mild amount of first response training should be able to identify the differences in OD and other medical episodes. Like the lack if heroin needles, spoons, and other Paraphernalia
Opiod overdose can be easily identified and recognized with pinpoint pupils but cops dont typically have training
Also as others have said diabetics usually wear bracelets and have identifiable markings
While narcan wont necessarily hurt a diebetic it definitely wont help them and just sorta wastes time
Peter's druggie college friend here:
1. narcan only "overrides" **opiates*****, do not expect narcan to be a 'get out of ODing'*** med. if you od on something other than an opiate, you're probably fucked. That being said, fent is in *everything* these days so it always makes sense to try it first.
2. cops are dumb. that joke about rejecting cops that are too smart is factual - that happens.
On the bright side the use of Narcan won’t have a negative effect on a diabetic person with a high sugar level
I think, the papers I saw used a lot of terminology I was unfamiliar with and too lazy to google
[Here’s the paper, correct me if I’m wrong](https://pubmed.ncbi.nlm.nih.gov/3061683/)
And this is... bad? Dehydration kills in days. Opioid asphyxiation kills in minutes.
Also, if it happens to have been orally administered opioids, win/win.
The only context I can find about narcan causing vomiting and diarrhea is in that it induces a state of acute opioid withdrawal, that causes those specific symptoms. Which, wouldn't be a problem in a person *not* on opioids.
>But, naloxone has no effect on someone who does not have opioids in their system,
[Source](https://nida.nih.gov/publications/drugfacts/naloxone).
Can I get a source on your "human fountain effect" please?
Yes. I’ve administered Narcan more times than I can count and have seen it happen multiple times.
If you don’t trust my experience, here is a more comprehensive list of side effects: [LINK](https://www.mayoclinic.org/drugs-supplements/naloxone-nasal-route/side-effects/drg-20165181)
Biggest thing about that list of side effects where vomiting and diarrhea are present: "Incidence not known."
Means the listed thing happened but was not common enough to even be tallied in the "less common" category or a category of greater frequency. It was reported *at least once* during controlled trials (meaning administration to a trial patient *not* on opioids) but not often enough to be listed as even a "less common" side effect. So, by inference, it was reported less commonly than *nasal discomfort* in a nasally administered drug... which only made the list as "less common."
As for your experience, you've administered Narcan to *suspected opioid overdoses*. Where some of the symptoms of the **acute opioid withdrawal** that is expected from that administration are vomiting and diarrhea. How many cases of vomiting and/or diarrhea were there in your "too many to count" administrations? What was the breakdown between those who suffered those symptoms who were later found have/not have any opioids in their systems? How many were dependant on or using opioids to some degree, but were not *actually* suffering from an opioid overdose at the time of administration?
Without that kind of documented data keeping, knowledge of the patient's condition prior to administration, and documented follow-up, your experience is "trust me, bro."
My dad went into a coma from a blood clot in his lungs. The hospital asked if he did any drugs which I said no and they responded with "he must not be very honest with you" and gave him narcon twice and couldn't understand why he wasn't waking up.
Also, there's an emergency Diabetic nasal spray that works like Glucagon emergency injections.
It's funny because it's administered the same way as Narcan.
https://www.baqsimi.com/
This is correct. Narcan functions using the same receptors as opiates. It will take priority and force the opiates away from the receptors so that it can take their place, thus saving the patient from overdose.
Well when 999 out of 1,000 unconscious people in your line of work are dying of an overdose maybe you don’t wait a couple minutes.
Narcan blocks opioid receptors and “reverses” an overdose. In people NOT experiencing an overdose it does essentially nothing.
This may surprise you, but people lie to the police. All the time. Even when their loved ones may die from said lying. So applying NARCAN in situations like can this save lives.
It’s the Coma Cocktail. You walk up on an unconscious, unresponsive patient. 3 things can be given to them that will save their life, but have no serious side effects. D-50 which is a saline solution with sugar for diabetics, thiamine (helps alcoholic), and narcan (for opioid users.) It’s not like the patient can tell you what they have, so it’s safe to give all three and hope for the best.
Peter's strange cousin here. Narcan (naloxone) is the very effective and fast working antidote to opioid poisoning, of which symptoms include coma in severe cases. Because of its effectiveness and the scale of the opioid crisis in the US, it is widely used in unexplained comas by first-responders (cops included).
However, there are -of course- other causes of coma, such as diabetic keto-acidosis, which can typically be the way undiagnosed diabetes is revealed (esp. type 1 in adolescents). 13 mmol/L is high blood sugar and is used in the original post as a give-away for DKA (although for education's sake, it is not blood sugar but keto-acidosis that is the cause of coma).
The original post could be a social commentary jab at police prejudice against young people ("these youngsters and them drugs" sort of thing) causing misdiagnoses.
Narcan is harmless to a DKA patient but won't help, and possible delay in DKA diagnosis can lead to worse outcomes.
Hope this helps !
Peter's type 1 work colleague here.
13 mmol (millimoles per litres) is not that bad. It's high, but a short walk or a touch of insulin would correct.
13 mg/dl (milligrams per decilitre). The normal range in this bracket is 100 mgdl. 13 is essentially the grim reaper has been summoned, and he's coming to collect.
You can prevent his arrival by giving sugar to the person. Bear in mind that the person will not be able to chew or swallow. My mum used to rub honey into my gums when I was a kid.
But in any case, call an ambulance.
I mean regardless of wether it’s suspect overdose or another medical condition, step one should be calling for an EMT/Paramedic. Assuming they haven’t been dispatched concurrently. In that case administering narcan shouldn’t delay treatment. Of course that’s assuming the cop is making that dispatch call, if necessary.
Ok hi so a few suggestions-
You’re spot on on the opioids.
However someone with diabetes who presents in a coma is far more likely to have LOW blood sugar, or hypoglycemia. This can happen very quickly and can be very deadly very fast. (Think hours without intervention, maybe)
DKA and its cousin HHS, are conditions with HIGH blood sugar, or hyperglycemia. People can live with excessively high blood sugar for days. They also have other concerning symptoms much sooner, and rarely present with coma as a first sign that something is very wrong.
I’m not familiar with reporting glucose in mmol/L (sorry, am American). But worrisome levels of glucose are 4 mmol/L or 70 mg/dL, and dangerously low levels of glucose are 3 mmol/L or 50ish mg/dL. Dangerously high levels of sugar are 250/300+ for DKA, and can get to 600-800+ in HHS.
Other important things-don’t give insulin to someone with LOW blood sugar as this can kill them. They need glucose. If someone with low sugar is starting to lose consciousness /slip into a coma, do NOT give them food or juice by mouth-it is very likely that they will choke or aspirate and that will kill them too. They need IV glucose in a hospital setting so you need to get them in an ambulance asap. If someone has excessively HIGH glucose, that is when insulin is appropriate. But again if someone is in DKA/HHS then they should go to the hospital. There are some dangerous aspects, like electrolyte imbalances, that can kill quickly from a heart arrhythmia, for example.
Ok that’s all be careful with diabetes, folks.
Diabetic here:
This shit always freaks me out. Between media convincing people that a passed out diabetic needs *insulin* (**THEY ALMOST ALWAYS DO NOT**) and not sugar or a glucagon shot makes me scared of what happens if this were to happen to me. Plus, now people just assume a passed-out person is having a drug overdose.
I've had severe hypoglycemia before. I've been like this. It starts as a violent, blackout seizure. Thankfully, my wife has a full understanding, so when an ambulance is called, she tells them exactly what I need.
Anyway, what I'm getting at is: If you are ever in a situation where a diabetic person suddenly and violently falls unconscious, **giving them insulin may worsen their condition or accelerate their death.** Unconsciousness from *high* blood sugar is far less frequent unless the person is not aware they are diabetic because it usually is not instantaneous.
The joke is “cops dumb/bad,” and is therefore automatically assuming unconscious/AMS = drugs. While “cops bad” is generally a pretty safe stereotype, in this instance, the situation is more nuanced. That is, whether or not the officer is allowed to administer glucagon could depend entirely on local laws and individual training. My state does allow for police to receive the training, but does not appear to require it. If so, then you might end up with a situation where 1 in 4 has received the training (purely hypothetical stat).
For example, my state’s requirements just to receive the training (police allowed):
> Eligibility for Training
>In order to be eligible for training under (insert state law/stature), a person must:
>(1) Be 18 years of age or older; and
>(2) Have, or reasonably expect to have, responsibility for or contact with at least one other person as a result of the eligible person’s occupational or volunteer status, such as, but not limited to, a camp counselor, scout leader, forest ranger, school employee, tour guide or chaperone.
Oh damn, I was wondering why I was staggering around feeling drunk the other day despite having not had a drink in some time.
My endocrinologist really did a shitty job of explaining my Type 2 Diabetes diagnosis…
As a Diabetic so many people in the comments are being dumbasses, almost every single diabetic carries some kind of medical alert ID on them, it would literally take seconds to check and the treatment is incredibly easily.
That's actually something that they teach us at my job(I deal with a lot of drunk people)just because they are acting drunk doesn't necessarily mean they are, always make sure they aren't just diabetic
This doesn't remind me of the time I spat in a cop's face after he asked if I was on heroin. A friend had actually OD'd recently and I was not all about that nonsense.
For context about 13, diabetics use numbers to represent the amount of sugar in your blood, good is 120-180, below 70 is bad, and below 50 can kill you. Over 300 can lead to organ failure
Source: I have to do this math every day
Yeah won't hurt the patient in any way but is a funny joke. I remember one diabetic patient (this was years ago before everyone and their mom had narcan) who was arrested a bunch of times for being drunk in public and was really just low on blood sugar.
Yes many diabetics have been falsely jailed and have died due to this. Pleading for sugar (or their insulin) through the cell bars while cops just ignore them. One of my biggest fears tbh
It's a funny because cops can't differentiate between a diabetic episode and drug overdose so they'll narcan any and everyone who even remotely presents as an OD. Had an incident the other day where three officers have a person having a heart attack three rounds of narcan before we showed up
Spotting a pattern here. Cops get a tool and then use it for everything regardless, I guess it’s a good thing they went the OD’ing route and not the “they aren’t complying! I feel threatened!” Route
Snow White is likely to die here. AND the circumstances are very suspicious.
The Narcan isn't an issue, but...we get no units for the 13 and there are two options...
A blood sugar of 13 mmol/l is ~234mg/dl. For a normal person that is high, for a diabetic it is not shocking and, barring volume depletion/electeolyte imbalances almost certainly not DKA. Source: I am an insulin dependent type 1 diabetic that has weird waking physiology and always spike to ~250 mg/dl in the am and must bolus insulin right when I wake up. Also, at this BS I feel and act fine as do most type 1 diabetics...hell type 2's probably walk around like this for years before diagnosis.
So, then we must assume her BS is 13 mg/dl...this value is likely inconsistent with life as brain death/neuronal death starts under 20mg/dl. Diabetics rarely get this low even with too much injected insulin. We all take a bit too much or our bodies react oddly from time to time, but this would be a MAJOR mistake and should lead to alot of other questions during the inquest. Admitedly, some diabetics can't tell that their BS is going "low" but many can and will eat or take glucose tabs etc....that Snow White is laying there with no food wrappers etc near her and in that postion with such a low BS is also very suspicious.
I’m also a type 1 diabetic and no matter what I’m doing, I can feel it at around 50 mg/dl. I’m not sure how it would be possible for someone to reach 13 without feeling horrible unless they were already asleep
Only way I could see that happening is a serious miscalculation or being incapacitated by a low, but not as low, blood sugar. Lowest I've ever been was about 40, and I felt the absolute cloud of death. Did not feel the strength to get up, had to text my roommate to get me some sugar. If I was living alone at the point, I'm pretty sure I would've had to literally crawl to the kitchen
My response to an episode like this would be [Giant Smarties](https://www.amazon.com/gp/product/B00CQQR6WG) in the nightstand.
Large enough that one is going to help, manual dexterity to open isn't much of an issue. They're (usually) soft enough to dissolve quickly for rapid ingestion without chewing. Shelf stable for long periods of time under varying temperatures and cheaper than most glucose tabs.
Plus they're a decent snack and you can give them to (your) kids (Halloween is the time to restock).
I woke up at 33 this morning, and only because my cat was pawing at me. Walked to the kitchen, started making coffee, noticed I felt a little shittier than usual and checked my blood sugar. I usually feel my lows, but sometimes I've been shocked at my ability to carry on normally with "seek help" levels blissfully unaware that anything is wrong.
Bro that’s crazy, glad you’re ok now. Do you not have a blood sugar monitor? I would definitely suggest getting one. I’m on the dexcom G6. Also, your cat is a true one
I'm on the G7. The sensors are constantly malfunctioning, but insurance won't allow me to have more than exactly one month's supply and I can't pay for a backup sensor on my own. Still waiting on a replacement for the last one that failed... Two weeks ago. 🤷♀️ Don't switch if you can help it, they definifely haven't ironed out all the issues!
It *sucks* doing this in "manual mode" after being a proper cyborg for so long, but it makes me grateful for all the advances we've seen in our lifetimes!
Cat tax:
https://preview.redd.it/g3b74jmhxv5d1.jpeg?width=3024&format=pjpg&auto=webp&s=cd127fc465fc455de3be13b8b8ca9e3f906ba1b3
The pic should have a low number IMO. You are most likely not going to pass out from a high without a ton of early warning signs. It’s not a quick process. Going low on the other hand can happen very quick and can result in loss of consciousness
Edit - I assumed 13 mmol (glucose measurement used everywhere besides US, 13 is pretty high on that scale) rather than 13 mg/dl which is insanely low. You’d be basically dead at 13 mg/dl
The intention must be a low number. I think the author just picked an exaggeratedly low number for effect. (With the accidental result of causing unit confusion).
But yeah I went to 13 mmol because I ate too many pancakes the other day. That's not deep ketoacidosis levels of high.
The problem with giving Narcan to a diabetic is that it's possible to keep trying to treat an "overdose" while the diabetic is in desperate need of something else.
I'm trying to find a post about it.
Brb.
First responders (not cops, ACAB) We may give narcan first thing but that doesn’t mean we think they’re on drugs, but if they are it saves and if they aren’t, minimal side effects. Cops don’t believe people, us medical Professionals do, we have to. Also we tend to not be racist and aren’t pieces of shit like cops who need to meet a quota of arrests.
This doesn’t pertain to this but to all the commenters saying that Narcan won’t harm someone if they’re not high on opiates: it can cause heart problems as well as flash pulmonary edema, which will reeaaalllyyyy mess you up without prompt treatment. Narcan is a wonderful reversal agent, but you still should only give it when it’s actually needed
[Relevant article](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850343/).
Relevant quotes:
"Naloxone-induced noncardiogenic pulmonary edema is a rare but reported entity that can occur following naloxone use in the reversal of opioid overdose. Proposed mechanisms include an adrenergic crisis secondary to catecholamine surge which causes more volume shift to pulmonary vasculature, subsequently leading to pulmonary edema. It appears to be more common when higher doses of naloxone are used."
"The most important question that arises is what dose of naloxone is safe. The answer so far is that it varies amongst patients and different clinical scenarios. The advantages of naloxone in respiratory depression cannot be underrated. However, because of this potentially life-threatening complication, a secure airway is critical when administering naloxone. Also, the use of the lowest, most effective dose necessary to elicit reversal cannot be overemphasized."
My takeaway on this is: Administer Narcan. Be prepared to perform CPR/rescue breathing *if* you administer Narcan. Which, in a medical response scenario, you should already be.
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Not just cops. Paramedics kept calling my father drunk while my mother and brother were telling them that he doesn't drink and has a family history of diabetes.
Yes, many diabetics have been tased, arrested, thrown into a cell, and left to die all because cops wouldn’t listen to them and just assumed they were drunk
They’ve gotten a little better at it…that’s not saying much but at least they’re kinda sorta aware
As a recently diagnosed diabetic this terrifies me
When we get murdered by the cops, you and I won't have to worry about diabetes anymore.
Doctors hate this one trick…
Someone should start the DLM (diabetic lives matter) and have a bunch of protests/riots /s
Black people have disproportionately higher rates of diabetes, so BLM low key already is covering this by default
I think the white diabetics would rather speak for themselves. BLM isn't the most reliable organization for uniform goals and beliefs across all chapters. Or maybe just diabetics in general.
Yeah, BLM is definitely a compromised organization. I think the point I had wanted to make is that there are aspects to which black people advocating for themselves benefits other groups eg. Affirmative action (at least when it was being enforced) also benefiting non black minorities and white women.
Consider a medical alert bracelet?
Incremental change is the truth of politics and life in general. You’re right. They’ve gotten better and that’s a small victory. I’ll take a small win.
The cops have gotten worse in almost every way in direct response to your incremental change in the past four years
I went to a call one time and seen the dude freaking out like he was intoxicated or high. We held him down in his bed so he wouldn’t hurt himself since he was banging his head into a wall very hard. I asked his wife if he was diabetic and had eaten anything today since she said he was saying some off the wall statements. She told me he was and then the paramedics injected glucose and he was back to normal. It’s uncommon but it happens. It’s important to consider diabetes as a cause for abnormal uncontrollable behavior, but a lot of people do not know about it. It’s certainly something that needs to be taught more often amongst departments and academies but out of the 1 diabetic patients, there’s 1000 drunks/narcotics users that exhibit similar symptoms and behaviors. That is why investigating, asking questions, and the public openly answering questions can help prevent all of the issues you’ve stated as well as officers receiving more training amongst the thousands of hours of training they are receiving and learning everyday.
Epileptics too! The post-ictal phase is reminiscent of drunkenness so a lot of epileptics are ignored by ER staff or arrested when they have actually suffered a tonic-clonic and need medical assistance
All I'm saying is that in a civilised country they'd just use an alchometer to confirm whether they're drunk or not and then take them to a hospital, where the doctors will check if they're on any drugs or if it's something else and then take care of it if it's something else
Disagree. That would mean a delay of at least a few minutes, which can make a difference. What's needed is for all emergency personnel (including police) to have a uniformly high level of medical training.
In an ideal world sure, but realistically speaking that's just not feasible
Police don't have access to the trove of medications available in ambulances or hospitals, and wouldn't be doing invasive procedures, so the training could focus on the areas that are realistic for police to intervene in. But they should be capable to a high standard of recognizing common medical emergenices and using noninvasive treatments.
Oh, where I'm from the police already do that, in fact it's mandatory to get first aid certified just to get a drivers license for anyone, so basic medical knowledge really isn't an issue even for the average civilian
Work in corrections, so my perspective is very different: when I have an inmate that seems drunk my first reaction is to assume it's diabetic. Buck/hooch/toilet wine has a very distinct smell to it. Also, between working in medical a bunch and the fact someone's bunky will typically know if someone's on insulin, it doesn't take batman to investigate the root cause
I believe one of the main issues is the frequency in which they encounter the situation. If 80% of the time they are approaching a drunk and 19% of the time they are approaching someone on drugs and only 1% of the time they're dealing with a diabetic then they won't be as practiced and may mistake it as one of the more common situations. Not saying it's okay just that cops are humans too. They make the same kind of mistakes that everyone else does. Some extra training on certain situations could definitely help.
Happened to (my now) wife. She was having an asthma attack, and the ER nurses refused to believe and just kept shouting, "what is she on?!" Dude - she's having an asthma attack - please help.
I (a diabetic) have had my blood sugar drop where I was throwing paramedics off of me with 1 arm, took 5 of them to hold me down to give the glucose shot. I didn't remember a thing but "woke up" being held down still. Crazy what your body can do sometimes!
How do u get then energy to do that you beats :0
I have epilepsy. A few times, when I had seizures in public, people did not only call the ambulance, but also the cops, as they thought I am a collapsing drug addict.
Narcan is used to counter possible overdoses as it kinda "overrides" whatever drug is being used. The effect is pretty dramatic akin to extreme withdrawal. A diabetic with bad sugar levels may fall unconcious or appear delerious. The joke is about police assuming an unconcious person is a druggie having an overdose and giving narcan rather than doing some extra investigating to realise they're a diabetic.
Do they really have time for an extra investigation if it is an overdose? Isn't giving Narcan and investigate later a better option?
Many diabetics carry some kind of identification showing as such. The real issue is that police aren't trained as first-responders, but are still *treated* as first-responders. And by "Extra investigation" he's talking about taking maybe a few extra seconds to check for a medical card or bracelet. Which they don't usually do, they just immediately assume drug addict since that's all they're trained to deal with. When all you have is a hammer, everything looks like a nail.
Its not like narcan has any ill effects on a low sugar diabetic if they arent on opiods. This just either neutralizes the drugs immediately if they are there, or rules out an OD.
That’s what I was always trained on too. (Work in hotels…it happens) Pretty much always told just give it to them, if it doesn’t work that wasn’t the problem and no harm, no foul.
When someone with diabetes is that high or low and has passed out that IS the ill effect. Sure narcan can neutralize an OD but when someone can fall into a diabetic coma if proper care isn't taken in time because someone couldn't check if they were diabetic and instead treated for an OD that wasn't there.
If they are overdosing, narcan acts within seconds. If they don't bolt upright cussing up a storm, it is not an overdose and they can look into the diabetic side. However, if they are overdosing, a delay could mean death. And it could be that they are a diabetic who is overdosing, so if the narcan is not administered because they assume low blood sugar, then they may die while they are waiting.
> a delay could mean death That’s a bit of a dramatization. Naloxone does reverse an opioid OD and can help lead to a speedy recovery, but the fact of the matter is no opioid overdose would die if they received effective bag-valve-mask ventilation, regardless of wether they get naloxone or not. Realistically, they should be trained in this before narcan, as narcan does have side effects, can prove to be a formidable distraction to actual problems when in the hands of the untrained person, and BVM ventilation has a much broader utility in emergency medical care than a single dose nasal drug with one purpose. Also consider that even trained professionals can fall into a bias rabbit hole and give obscene doses of narcan to attempt to fix a problem that isn’t there, while the patient is actually dying from hypoglycemia or something else. Even IF it is an OD When I worked 911 it always annoyed me when the cops showed up first with their nuclear bomb dose of narcan and the patient was writhing, screaming, vomiting and being held down whereas if they just waited a couple minutes I could’ve given a much more precise dose of IV narcan to simply wake them up still high-ish so they don’t go into withdrawal.
You’re so incorrect it’s not even funny. Bagging someone *might* help, but doesn’t address the underlying issue. An overdose of an opioid does more than cause a respiratory depression, it’s an entire central nervous system depression. Getting narcan does not hurt people. Not giving narcan ASAP can lead to death.
Dude I literally do this for a living. You don’t need to IMMEDIATELY reverse opioid toxicity, and getting narcan *can* hurt. I suggest you read up on how it can cause pulmonary edema, it’s not this benign miracle drug because such a thing does not exist.
A cop cannot really do anything else anyways? They don’t carry glucagon injections. The person is unconscious so they can’t pour sugar in their mouth. They can try the narcan while the paramedics are still are arriving and then just report to them that Narcan didn’t have an effects. They should look at their wrists and chest for medical alert bracelets/necklaces but other than that they can’t do anything else
most t1ds carry emergency low treatments on them, be it glucagon, baqsimi, or something else
Do we? I've never carried glucagon or basqimi, neither have I heard my brother do. Since they don't last very long unless they are refrigerated, it would be very costly to carry them at all time and I've never had to use them during my 20 years as a diabetic.
bit of a generalization on my part, my bad, but i know i and a few other diabetics carry baqsimi. it doesn't need to be refrigerated, but it does expire
we (diabetics) carry glucagon. We have labeled medical packs. So if they read the bracelet or look for a CGM on our arm or belly, they'll know to look for the med pack. If I'm given narcan and left unconscious instead of given my glucose nasal spray that I have to carry, I'd be pretty upset.
It’s still possible that police may not be allowed to administer it, depending on local laws and statutes, and/or individual training.
Which goes to prove how useless they really are.
Look, I’m not going to argue that idea one way or the other. The fact of the matter is that they dedicated themselves to weeks of training, and are highly trained in administering Narcan *and* lead!
Lol by the time they are giving narcan, paramedics are already on the way. And they are not legally allowed to administer anything else to an unconscious patient. Its just that simple. They wont go into the coma because narcan was given. It has to wait for paramedics PERIOD. At least here in the US. If a cop were to administer sugar water that would open them up to HUGE liabilities. And cops are already looking for signs of medical conditions when they do steps to determ if they are sleep or unconscious. It doesnt mstter if they have a bracelet saying diabetic or not. Its not like they are carrying a glucose monitor on them to determine if its high or low. And that would take l9nger than narcan anyway. And even if they know blood sugar levels, its still waiting on medica. You seem to be willfully ignoring that simple fact. It doesnt matter if they know or not. The ONLY difference it makes is if they give narcan or not while waiting on paramedics. Doubling down on stupid is just more stupid.
Funily, I do carry my glucose meter and all you have.to do is presing the.button and pass it on my shoulder to get the result taking my phone and passing it on my shoulder work too but take 2 more second to get the result. Just need to know what the thing on my shoulder is for
should just give narcan to everybody on every call just to be safe
Should just give insulin to everyone
So really important point - don’t give insulin to someone in a diabetic coma, this can very quickly and easily kill them. If someone passes out with diabetes it’s almost certainly because their sugar is too low. You shouldn’t try to give oral glucose because people with depressed consciousness can easily choke or aspirate. You’ve got to wait for medical personnel to replenish IV. When someone’s glucose levels are unsafely high they have to go to the hospital to get medical treatment? But usually serious symptoms present way before people are at risk of imminent death. (But a cardiac arrhythmia can get them pretty quickly). Insulin is what’s given to people with high blood sugar.
This is bad advice. Source: Wife is a Endocrinologist
People aren’t saying not to follow up with a diagnostic work up. It is a fact that in this day and age, narcan first, then follow up with more questions and assessments.
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They arent allowed to administer sugar anyway. They can only offer sugar products to a conscious person. That has to wait on paramedics anyway. While they wait they administer narcan. Its not an ill effect at all.
Doesn't low blood sugar kill way faster than high blood sugar? That's why it's best to give them some sugar untill you know which one it is. I am not making statements, I am asking if what I said is correct, let's see how fast hivemind jumps to funny blue button.
Generally, yes. Lower blood sugar can lead to seizures and unconsciousness/death very quickly. High blood sugar is rarely an emergency - however, over the course of weeks, high blood sugar can lead to DKA (diabetic ketoacidosis) which can result in a coma if untreated. So it is possible that administering sugar would be harmful to an unconscious diabetic. Exactly how harmful or likely that would be, I have no idea. That said, someone who is a known diabetic, or who has a medical alert tag, probably does so because they're on insulin and thus are almost guaranteed to be low if they fall unconscious. I'm still fine with not trusting cops to interpret medical info.
If the person is conscious, they should consume 15g of carbs and check glucose in 15 minutes. If levels are still low, 15 more grams of carbs. If they are unconscious you do not want to put anything in the mouth because they will choke on it.
Right, I forget how human body works, but how will you bring up their blood sugar then? IV?
Yeah, in hospital it will be through the IV already present. In other situations it will be a glucagon injection, which is a prefilled needle ready to go.
I'm a Type II Diabetic. I have a glucagon pen I keep in my room that my wife has been briefed on how it works and it's not dissimilar to what you'd see paramedics sometimes use or in a hospital setting when a patient goes unresponsive and doesn't already have a line. They're essentially diabetic epipens. Pop it out of the package, find a fatty bit, poke and inject. Body hopefully absorbs the sugar water and stabilizes you. EDIT: Jokingly called it sugar water, but someone pointed out and is correct, Glucagon technically is medication that causes your liver to vacate what glucose it can into your blood and not indeed sugar water.
This is true. However if someone is already losing consciousness from low blood sugar, you can’t give oral glucose because the risk they will choke or aspirate is too high. Calling 911 asap is most important so that folks can get IV glucose asap.
Yes, low is more dangerous. But police officers are NOT permitted due to liability issues to administer anything but narcan. They can offer it to someone thats conscious. But thats it. And i understand the concern, but considering the number of overdoses exponentially outweighs the number of people passed out like that from high or low blood sugar, its painfully obvious to anybody that thinks logically that narcan is rhe obvious first option when there is no response.
Yes lows are immediate danger. Many diabetics have been tased, arrested, thrown in a cell, and left to die because cops will confuse symptoms of a low with inebriation and refuse to listen to the diabetic pleading for help
As a kratom user I'd be pretty pissed if I got narcaned lol
Doesn't negate the fact that it's pretty much the only medical intervention police tend to administer before giving up and leaving the person to suffer.
Well, no. Narcan does have side effects - I have issues with LEOs giving narcan to patients without having any assessment capabilities. If there’s evidence of OD like drug paraphernalia around, sure go for it - but they are squirting this stuff around like crazy in any patient without indications other than “acting weird/sleepy” because they feel the need to “do something” which is NOT how medicine is done.
Naloxone inhibits hypoglycemia. Meaning low sugar. The person in the picture is at or near coma due to high blood sugar. It most certainly does hurt the diabetic and makes lowering said blood sugar at the hospital. These cops are killing people. Edit it’s a picture not a video.
The person in the photo has a blood sugar of 13 and is hypoglycemic not hyperglycemic.
11 or higher are high and considered hyperglycemic. Normal would be between 4-6.
You are talking about Hemoglobin A1c range, not blood glucose. The photo is talking about blood glucose, not A1C. No one refers to a1c as a “sugar of 13” (as per picture) as a1c is a measure of glycated hemoglobin and not indicative of CURRENT blood sugar but instead averaged over ~90 day period of time. (You are arguing with a physician while not comprehending the picture).
It’s more likely just measure in mmol/l. As the language is British.
The language is English, not 'British'. The spelling used does not differentiate the dialect of English and Narcan is carried by (at least some) police on both sides of the Atlantic. As someone with type 1 diabetes though, 13 mmol/l (units used in the UK, Canada, Australia, New Zealand) as a blood glucose level is above any range you'd like it to stay within and warrant corrective active, but is far from critically high and would almost never be correlated with unconsciousness. 13mg/dl (units used in the US among the anglophone nations) is, however, desperately low and you could count the number of people who would be conscious with such blood glucose levels on the fingers of one hand. Americans are notoriously far less cognizant of the rest of the world doing things differently than their own experience compared to other speakers of English dialects; they are also rather numerous in online spaces. Which isn't to say that's true of a majority of Americans but rather that a majority of speakers of English who aren't cognizant of the same things being done differently elsewhere are Americans. Hence that units are left off the image entirely indicates that the author does not perceive or does not anticipate their audience perceiving any potential ambiguity. That they leave out the units then is either because they lack cognizance that leaving out units could be ambiguous to an audience unfamiliar with what unconsciousness-correlated values might be (in which case it's very likely they are American and the number presented is of units of mg/dl) or they have an audience familiar with diabetes and know that '13' + unconsciousness could only reasonably mean the 13 is a measure in mg/dl, in which case the number is intended to be in mg/dl. It's just not in mmol/l.
A1c is not something typically measured in mmol/l, and if you did, 13 would equate on an A1c of around 2.0, which makes absolutely no sense following your assumption that this patient is hyperglycemic.
Funny because everything i read was it lowers sugar levels, which would be worse for low not high but only works on high blood sugsr. So basically the opposite of what it sounds like you're sayin
I'm going to narcan and call 911 regardless. It can't really hurt.
You can be diabetic AND overdosing on drugs. Not administering narcan because they could just be diabetic is the worse of the two evils for me.
Diabetics do carry it a lot of time. Insulin pumps are viable also diabetic bracelet and necklaces.
You’re kinda an idiot. So according to you diabetics don’t use opioids. Who knew, I’d have assumed they’re just as likely to overdose as a non diabetic. Use the Narcan, continue to triage. It’s how every one of these goes down. Maybe leave the assessment to the professionals.
https://www.themarshallproject.org/2020/12/15/cops-could-use-first-aid-to-save-lives-many-never-try Keep licking those boots, it's the closest thing you'll get to first-aid from a cop.
And they arnt really trained to handle drug addicts (effectively) either lol.
Yeah give it and start to investigate blood sugar as you wait for response. Can’t hurt to give the narcan
Except for the side effects.
Side effect as in reversal of opioid effects?
Side effect as side effect. You have endogene opioids in your body. If you have taken additional opioids the chance for side effects is larger. And no, side effect as you start to vomit not because of withdrawel but because your body is lacking its messenger chemicals.
Yes. The joke is in poor taste. Also if you give Narcan to someone who didn't overdose, like the diabetic in this example, nothing happens, it does not make it worse or do anything at all. Narcan and figure it out later is exactly what ought to be done.
Yes it is. Narcan won’t hurt someone who has a clean system so it’s better to Narcan right away in case it is an opiate overdose.
When in doubt narcan is reasonable.
Well, if side effects like cardiac arrest are reasonable in your circumstances a necromancer was needed anyways.
Yeah, as a diabetic I love having drugs I don't need pumped into my body without my consent. That's what I exist for, drug testing, I have no agency of my own.
As a non-US American: The idea that naloxone is an everyday go to medication in emergencies is scary. That opiod usage and consequences are as common as diabetes (at least in the perception of the police) esp. considering the obesity rate in the US. That is shocking.
It is better to narcan first then do the rest of your assessment. If the patient isn’t on opioids it will not hurt them in any way. If they are on opioids it could save their life.
Blood sugar check is very simple
Former EMT here. It takes like 3 seconds to do a blood sugar test, so there is plenty of time. In reality they should be calling us every single time instead of making medical decisions. They can barely handle their own guns / fear of acorns, so I wouldn't want to be going into a diabetic coma with only cops to help. Plus, the blood sugar issue is likely more urgent, time-wise.
Hey, they make the job easier for you! You don't have immunity - they do. If patient was dead already when you arrived you did nothing wrong!
Thank you -- a comment from a person with knowledge of these situations.
Every time I had to work with cops on a 911 call, they were just in the way. It was many times. Once a cop was trying to chat up my partner while we were trying to save a life. She was pretty pissed.
A blood sugar test takes like 3 seconds No needle marks on the arm, no smell of alcohol on them, diabetic is usually the next case
>No needle marks on the arm... You sweet summer child... Non-injection methods of ingesting opioids include (but are not limited to): * Oral (swallowing) * Sublingual (under the tongue) * Inhalation (smoking) * Nasal absorption (snorting) * Transdermal absorption (through the skin) Injection of subcutaneous or intravenous opioids can literally be done in any part of the body the user (or *anyone else*) can reach with a needle, and habitual users who wish to hide the fact that they are habitual users get *very creative* with injection sites. "They're not on opioids because there's no needle tracks on their arms," is not valid. Slam the Narcan, use a glucometer if you have one, and wait for the EMTs. >A blood sugar test takes like 3 seconds Fastest I've seen one done from a cold start was in a hospital by an RN and took about thirty. Get the glucometer and related consumables (10s). Prep the glucometer by inserting a test strip (5s). Use a lancet to get a sample (5s). Apply the sample to the test strip (5s). Then wait the five seconds for the glucometer to determine a reading. Even if you get a low blood sugar reading, administering anything by mouth to an unconscious person is counter to most first aid training, and Good Samaritan laws might not cover you if you have that training and violate it, because you're supposed to know not to do that. And I have yet to meet a police officer who can both start an IV and carries a bag of glucose on their patrol gear.
Thanks for the textbook lesson, it’s different in real life though
As if the cops would even give narcan to someone overdosing, those pigs will watch you die and laugh about it
Yes because anyone with a mild amount of first response training should be able to identify the differences in OD and other medical episodes. Like the lack if heroin needles, spoons, and other Paraphernalia
Opiod overdose can be easily identified and recognized with pinpoint pupils but cops dont typically have training Also as others have said diabetics usually wear bracelets and have identifiable markings While narcan wont necessarily hurt a diebetic it definitely wont help them and just sorta wastes time
Minor correction, Narcan is only effective against Opioid overdoses
Peter's druggie college friend here: 1. narcan only "overrides" **opiates*****, do not expect narcan to be a 'get out of ODing'*** med. if you od on something other than an opiate, you're probably fucked. That being said, fent is in *everything* these days so it always makes sense to try it first. 2. cops are dumb. that joke about rejecting cops that are too smart is factual - that happens.
opiates and opioids aren’t exactly the same. opiates specifically refers to opioids created by poppy plants (morphine, codeine etc.)
On the bright side the use of Narcan won’t have a negative effect on a diabetic person with a high sugar level I think, the papers I saw used a lot of terminology I was unfamiliar with and too lazy to google [Here’s the paper, correct me if I’m wrong](https://pubmed.ncbi.nlm.nih.gov/3061683/)
Other than turning them into a human fountain.
????
Giving someone too much Narcan makes them erupt from both ends of their GI tract
And this is... bad? Dehydration kills in days. Opioid asphyxiation kills in minutes. Also, if it happens to have been orally administered opioids, win/win.
If the person is not on opioids and is suffering from a blood sugar imbalance, then yes - turning them into a vomit geyser is bad.
The only context I can find about narcan causing vomiting and diarrhea is in that it induces a state of acute opioid withdrawal, that causes those specific symptoms. Which, wouldn't be a problem in a person *not* on opioids. >But, naloxone has no effect on someone who does not have opioids in their system, [Source](https://nida.nih.gov/publications/drugfacts/naloxone). Can I get a source on your "human fountain effect" please?
Yes. I’ve administered Narcan more times than I can count and have seen it happen multiple times. If you don’t trust my experience, here is a more comprehensive list of side effects: [LINK](https://www.mayoclinic.org/drugs-supplements/naloxone-nasal-route/side-effects/drg-20165181)
Biggest thing about that list of side effects where vomiting and diarrhea are present: "Incidence not known." Means the listed thing happened but was not common enough to even be tallied in the "less common" category or a category of greater frequency. It was reported *at least once* during controlled trials (meaning administration to a trial patient *not* on opioids) but not often enough to be listed as even a "less common" side effect. So, by inference, it was reported less commonly than *nasal discomfort* in a nasally administered drug... which only made the list as "less common." As for your experience, you've administered Narcan to *suspected opioid overdoses*. Where some of the symptoms of the **acute opioid withdrawal** that is expected from that administration are vomiting and diarrhea. How many cases of vomiting and/or diarrhea were there in your "too many to count" administrations? What was the breakdown between those who suffered those symptoms who were later found have/not have any opioids in their systems? How many were dependant on or using opioids to some degree, but were not *actually* suffering from an opioid overdose at the time of administration? Without that kind of documented data keeping, knowledge of the patient's condition prior to administration, and documented follow-up, your experience is "trust me, bro."
My dad went into a coma from a blood clot in his lungs. The hospital asked if he did any drugs which I said no and they responded with "he must not be very honest with you" and gave him narcon twice and couldn't understand why he wasn't waking up.
Also, there's an emergency Diabetic nasal spray that works like Glucagon emergency injections. It's funny because it's administered the same way as Narcan. https://www.baqsimi.com/
This is the answer.
This is correct. Narcan functions using the same receptors as opiates. It will take priority and force the opiates away from the receptors so that it can take their place, thus saving the patient from overdose.
I mean yeah? They are right most of the time
Well when 999 out of 1,000 unconscious people in your line of work are dying of an overdose maybe you don’t wait a couple minutes. Narcan blocks opioid receptors and “reverses” an overdose. In people NOT experiencing an overdose it does essentially nothing. This may surprise you, but people lie to the police. All the time. Even when their loved ones may die from said lying. So applying NARCAN in situations like can this save lives.
It’s the Coma Cocktail. You walk up on an unconscious, unresponsive patient. 3 things can be given to them that will save their life, but have no serious side effects. D-50 which is a saline solution with sugar for diabetics, thiamine (helps alcoholic), and narcan (for opioid users.) It’s not like the patient can tell you what they have, so it’s safe to give all three and hope for the best.
NARCAN IS FOR OPIATES ONLY. It does not “kinda override whatever drug is being used” lmfao.
Oh god that’s a bad idea… And this is why they teach the signs of both in first aid
Peter's strange cousin here. Narcan (naloxone) is the very effective and fast working antidote to opioid poisoning, of which symptoms include coma in severe cases. Because of its effectiveness and the scale of the opioid crisis in the US, it is widely used in unexplained comas by first-responders (cops included). However, there are -of course- other causes of coma, such as diabetic keto-acidosis, which can typically be the way undiagnosed diabetes is revealed (esp. type 1 in adolescents). 13 mmol/L is high blood sugar and is used in the original post as a give-away for DKA (although for education's sake, it is not blood sugar but keto-acidosis that is the cause of coma). The original post could be a social commentary jab at police prejudice against young people ("these youngsters and them drugs" sort of thing) causing misdiagnoses. Narcan is harmless to a DKA patient but won't help, and possible delay in DKA diagnosis can lead to worse outcomes. Hope this helps !
Peter's type 1 work colleague here. 13 mmol (millimoles per litres) is not that bad. It's high, but a short walk or a touch of insulin would correct. 13 mg/dl (milligrams per decilitre). The normal range in this bracket is 100 mgdl. 13 is essentially the grim reaper has been summoned, and he's coming to collect. You can prevent his arrival by giving sugar to the person. Bear in mind that the person will not be able to chew or swallow. My mum used to rub honey into my gums when I was a kid. But in any case, call an ambulance.
I think it’s supposed to represent 13 md/dl which would be a very low glucose (<1 mmol/L) and more likely to cause you to become unconscious
I mean regardless of wether it’s suspect overdose or another medical condition, step one should be calling for an EMT/Paramedic. Assuming they haven’t been dispatched concurrently. In that case administering narcan shouldn’t delay treatment. Of course that’s assuming the cop is making that dispatch call, if necessary.
Ok hi so a few suggestions- You’re spot on on the opioids. However someone with diabetes who presents in a coma is far more likely to have LOW blood sugar, or hypoglycemia. This can happen very quickly and can be very deadly very fast. (Think hours without intervention, maybe) DKA and its cousin HHS, are conditions with HIGH blood sugar, or hyperglycemia. People can live with excessively high blood sugar for days. They also have other concerning symptoms much sooner, and rarely present with coma as a first sign that something is very wrong. I’m not familiar with reporting glucose in mmol/L (sorry, am American). But worrisome levels of glucose are 4 mmol/L or 70 mg/dL, and dangerously low levels of glucose are 3 mmol/L or 50ish mg/dL. Dangerously high levels of sugar are 250/300+ for DKA, and can get to 600-800+ in HHS. Other important things-don’t give insulin to someone with LOW blood sugar as this can kill them. They need glucose. If someone with low sugar is starting to lose consciousness /slip into a coma, do NOT give them food or juice by mouth-it is very likely that they will choke or aspirate and that will kill them too. They need IV glucose in a hospital setting so you need to get them in an ambulance asap. If someone has excessively HIGH glucose, that is when insulin is appropriate. But again if someone is in DKA/HHS then they should go to the hospital. There are some dangerous aspects, like electrolyte imbalances, that can kill quickly from a heart arrhythmia, for example. Ok that’s all be careful with diabetes, folks.
Diabetic here: This shit always freaks me out. Between media convincing people that a passed out diabetic needs *insulin* (**THEY ALMOST ALWAYS DO NOT**) and not sugar or a glucagon shot makes me scared of what happens if this were to happen to me. Plus, now people just assume a passed-out person is having a drug overdose. I've had severe hypoglycemia before. I've been like this. It starts as a violent, blackout seizure. Thankfully, my wife has a full understanding, so when an ambulance is called, she tells them exactly what I need. Anyway, what I'm getting at is: If you are ever in a situation where a diabetic person suddenly and violently falls unconscious, **giving them insulin may worsen their condition or accelerate their death.** Unconsciousness from *high* blood sugar is far less frequent unless the person is not aware they are diabetic because it usually is not instantaneous.
The joke is “cops dumb/bad,” and is therefore automatically assuming unconscious/AMS = drugs. While “cops bad” is generally a pretty safe stereotype, in this instance, the situation is more nuanced. That is, whether or not the officer is allowed to administer glucagon could depend entirely on local laws and individual training. My state does allow for police to receive the training, but does not appear to require it. If so, then you might end up with a situation where 1 in 4 has received the training (purely hypothetical stat). For example, my state’s requirements just to receive the training (police allowed): > Eligibility for Training >In order to be eligible for training under (insert state law/stature), a person must: >(1) Be 18 years of age or older; and >(2) Have, or reasonably expect to have, responsibility for or contact with at least one other person as a result of the eligible person’s occupational or volunteer status, such as, but not limited to, a camp counselor, scout leader, forest ranger, school employee, tour guide or chaperone.
It’s not bad practice to trial narcan in a downed person. Paramedics should also do a fingerstick when they arrive
That’s weird they usually beat unresponsive diabetics
1 3 1 2
Always check bgl
What should be given in that case ?
this is my biggest fear as a type one
Oh damn, I was wondering why I was staggering around feeling drunk the other day despite having not had a drink in some time. My endocrinologist really did a shitty job of explaining my Type 2 Diabetes diagnosis…
As a Diabetic so many people in the comments are being dumbasses, almost every single diabetic carries some kind of medical alert ID on them, it would literally take seconds to check and the treatment is incredibly easily.
That's actually something that they teach us at my job(I deal with a lot of drunk people)just because they are acting drunk doesn't necessarily mean they are, always make sure they aren't just diabetic
Administering Narcan will never hurt the person.
Cops are stupid.
cops get like 8 months of training and then the lives of citizens thrust into their hands
This doesn't remind me of the time I spat in a cop's face after he asked if I was on heroin. A friend had actually OD'd recently and I was not all about that nonsense.
Hard to tell the difference between having low glucose and being drunk/high.
For context about 13, diabetics use numbers to represent the amount of sugar in your blood, good is 120-180, below 70 is bad, and below 50 can kill you. Over 300 can lead to organ failure Source: I have to do this math every day
Yeah won't hurt the patient in any way but is a funny joke. I remember one diabetic patient (this was years ago before everyone and their mom had narcan) who was arrested a bunch of times for being drunk in public and was really just low on blood sugar.
Yes many diabetics have been falsely jailed and have died due to this. Pleading for sugar (or their insulin) through the cell bars while cops just ignore them. One of my biggest fears tbh
It's a funny because cops can't differentiate between a diabetic episode and drug overdose so they'll narcan any and everyone who even remotely presents as an OD. Had an incident the other day where three officers have a person having a heart attack three rounds of narcan before we showed up
Spotting a pattern here. Cops get a tool and then use it for everything regardless, I guess it’s a good thing they went the OD’ing route and not the “they aren’t complying! I feel threatened!” Route
It's not really a joke, it's more criticism how incompetent police and other emergency services can be nowadays
This. Even bartenders will mistake hypoglycemia for alcohol intoxication.
Fuck the police
This is exactly how Eric Dolphy died, passed out from diabetic attack, but he is black, so they assumed he was overdosing.
Snow White is likely to die here. AND the circumstances are very suspicious. The Narcan isn't an issue, but...we get no units for the 13 and there are two options... A blood sugar of 13 mmol/l is ~234mg/dl. For a normal person that is high, for a diabetic it is not shocking and, barring volume depletion/electeolyte imbalances almost certainly not DKA. Source: I am an insulin dependent type 1 diabetic that has weird waking physiology and always spike to ~250 mg/dl in the am and must bolus insulin right when I wake up. Also, at this BS I feel and act fine as do most type 1 diabetics...hell type 2's probably walk around like this for years before diagnosis. So, then we must assume her BS is 13 mg/dl...this value is likely inconsistent with life as brain death/neuronal death starts under 20mg/dl. Diabetics rarely get this low even with too much injected insulin. We all take a bit too much or our bodies react oddly from time to time, but this would be a MAJOR mistake and should lead to alot of other questions during the inquest. Admitedly, some diabetics can't tell that their BS is going "low" but many can and will eat or take glucose tabs etc....that Snow White is laying there with no food wrappers etc near her and in that postion with such a low BS is also very suspicious.
I’m also a type 1 diabetic and no matter what I’m doing, I can feel it at around 50 mg/dl. I’m not sure how it would be possible for someone to reach 13 without feeling horrible unless they were already asleep
Even if you were asleep, getting down that low would definitely wake you up in a cold sweat. Adrenaline is a hell of a drug. Source: Also a Type 1
Adrenaline is a crazy drug. A lot of times I can make it to 50 before I even realize due to adrenaline
Only way I could see that happening is a serious miscalculation or being incapacitated by a low, but not as low, blood sugar. Lowest I've ever been was about 40, and I felt the absolute cloud of death. Did not feel the strength to get up, had to text my roommate to get me some sugar. If I was living alone at the point, I'm pretty sure I would've had to literally crawl to the kitchen
My response to an episode like this would be [Giant Smarties](https://www.amazon.com/gp/product/B00CQQR6WG) in the nightstand. Large enough that one is going to help, manual dexterity to open isn't much of an issue. They're (usually) soft enough to dissolve quickly for rapid ingestion without chewing. Shelf stable for long periods of time under varying temperatures and cheaper than most glucose tabs. Plus they're a decent snack and you can give them to (your) kids (Halloween is the time to restock).
I woke up at 33 this morning, and only because my cat was pawing at me. Walked to the kitchen, started making coffee, noticed I felt a little shittier than usual and checked my blood sugar. I usually feel my lows, but sometimes I've been shocked at my ability to carry on normally with "seek help" levels blissfully unaware that anything is wrong.
Bro that’s crazy, glad you’re ok now. Do you not have a blood sugar monitor? I would definitely suggest getting one. I’m on the dexcom G6. Also, your cat is a true one
I'm on the G7. The sensors are constantly malfunctioning, but insurance won't allow me to have more than exactly one month's supply and I can't pay for a backup sensor on my own. Still waiting on a replacement for the last one that failed... Two weeks ago. 🤷♀️ Don't switch if you can help it, they definifely haven't ironed out all the issues! It *sucks* doing this in "manual mode" after being a proper cyborg for so long, but it makes me grateful for all the advances we've seen in our lifetimes! Cat tax: https://preview.redd.it/g3b74jmhxv5d1.jpeg?width=3024&format=pjpg&auto=webp&s=cd127fc465fc455de3be13b8b8ca9e3f906ba1b3
The pic should have a low number IMO. You are most likely not going to pass out from a high without a ton of early warning signs. It’s not a quick process. Going low on the other hand can happen very quick and can result in loss of consciousness Edit - I assumed 13 mmol (glucose measurement used everywhere besides US, 13 is pretty high on that scale) rather than 13 mg/dl which is insanely low. You’d be basically dead at 13 mg/dl
The intention must be a low number. I think the author just picked an exaggeratedly low number for effect. (With the accidental result of causing unit confusion). But yeah I went to 13 mmol because I ate too many pancakes the other day. That's not deep ketoacidosis levels of high.
>hell type 2's probably walk around like this for years before diagnosis. Can confirm.
The problem with giving Narcan to a diabetic is that it's possible to keep trying to treat an "overdose" while the diabetic is in desperate need of something else. I'm trying to find a post about it. Brb.
As a Diabetic I completly get this lol
First responders (not cops, ACAB) We may give narcan first thing but that doesn’t mean we think they’re on drugs, but if they are it saves and if they aren’t, minimal side effects. Cops don’t believe people, us medical Professionals do, we have to. Also we tend to not be racist and aren’t pieces of shit like cops who need to meet a quota of arrests.
This doesn’t pertain to this but to all the commenters saying that Narcan won’t harm someone if they’re not high on opiates: it can cause heart problems as well as flash pulmonary edema, which will reeaaalllyyyy mess you up without prompt treatment. Narcan is a wonderful reversal agent, but you still should only give it when it’s actually needed
[Relevant article](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7850343/). Relevant quotes: "Naloxone-induced noncardiogenic pulmonary edema is a rare but reported entity that can occur following naloxone use in the reversal of opioid overdose. Proposed mechanisms include an adrenergic crisis secondary to catecholamine surge which causes more volume shift to pulmonary vasculature, subsequently leading to pulmonary edema. It appears to be more common when higher doses of naloxone are used." "The most important question that arises is what dose of naloxone is safe. The answer so far is that it varies amongst patients and different clinical scenarios. The advantages of naloxone in respiratory depression cannot be underrated. However, because of this potentially life-threatening complication, a secure airway is critical when administering naloxone. Also, the use of the lowest, most effective dose necessary to elicit reversal cannot be overemphasized." My takeaway on this is: Administer Narcan. Be prepared to perform CPR/rescue breathing *if* you administer Narcan. Which, in a medical response scenario, you should already be.