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Is the Red Cross Wrong in the Advice they Give on Diabetic Emergencies?

I just got a new job in a gym and part of my training was to become Red Cross certified in First Aid. My instructor said if a person is a known diabetic, giving them more sugar water won't hurt them.

I come from a diabetic family (mom, dad, grandma, and 3 sisters) so I know a little about the disease. Couldn't you potentially kill someone by giving them more sugar and their level is too high already?

I tried to make this point to my instructor and she just ignored me and kept going with the lesson.

Am I wrong to be upset that the Red Cross is potentially training people in the wrong info on how to treat a diabetic? I would appreciate any and all help with this matter.

Public Comments

1. in a first aid situation, a diabetic can die from low sugar a great deal faster than from a high sugar, they are after all conditioned to higher levels of sugar in their blood stream, so, it is better to give them sugar if you don't know whether their sugar is high or low, rather than let them die from low sugar because you thought it might be high. naturally you will want to get an ambulance and trained help on the way as soon as possible, but that is the reasoning behind what the red cross teaches.

2. While giving a diabetic sugar water certainly won't help them (unless they're suffering from hypoglycemia, low blood sugar) it would not likely be life threatening.

Was your instructor perhaps talking about a common problem with diabetic's where the sugar levels drops, which can cause serious problems and even unconsciousness, at a minimum disorientation and to some the appearance of being drunk. In this case, you WANT to give them sugar immediately to increase their glucose levels.

However, if the diabetic is not capable of drinking a sweet beverage or eating a candy, you could put them at greater risk by trying to force feed. Calling 911 would be the only sensible solution in this case.

3. Its because its more common to die of low sugar than high sugar. They said give them a little bit of sugar, chances are if their sugar was already too high you aren't going to hurt them anymore.

4. Generally in a gym situation a diabetic will be struggling with low blood sugars rather than high. Yes, there are situations where exercise can raise your blood sugar, but it wouldn't be likely to be happening in the gym. Someone who is already running very high sugars who then tries to exercise could have them raise, but they would already be feeling ill from the high sugars and they would most likely stop of their own accord. It doesn't seem likely that a gym rat, someone used to working out, would be running high sugars like that because you feel fatigue and not up to exercising. The times I've seen it are when someone is newly diagnosed as a Type 2, their sugars are high, and they're just starting to walk more or do gentle exercise only to find it doesn't help their sugars because you should get your sugars down first, then exercise.

It's much, much more common for someone on diabetes medications to miscalculate a little on their insulin and end up with a low halfway through their workout. This is the most common reaction for blood sugars, to go down with exercise. So in your job, chances are you would never see someone running high enough sugars to be on the verge of diabetic coma, but chances are very good you will see a diabetic who gets low on their sugar and might need assistance.

5. I can understand why you're upset, but no, the Red Cross is not giving out wrong information regarding how to treat a diabetic.

When an individual is certified in first aid, they learn how to perform BASIC first aid skills - how to properly bandage, sling, how to treat bleeding, etc. They are not doctors/nurses, or anything to that degree.
The goal of first aid is to sustain life until "help" comes, or they victim can get to a hospital. People who are certified in first aid are not allowed/trained/whatever to administer ANY medication to ANYONE. For example, if someone has an epi pen, you need to get THEM to give it to themself before they go unconscious, because even if it's right there, someone trained in first aid can't give it to a victim.

People who are diabetic need to use (depending on the type, severity, etc.) their diet and synthetic insulin to keep their blood sugar levels "balanced", as their bodies cannot do this for them. That is why you'll hear people discussing "low" and "high". When their blood sugar is low, they go unconscious, and could potentially die. When their blood sugar is high, yes it's POSSIBLE for them to die if it gets extremely high, but very unlikely - comparable to crossing a street - a car COULD hit you, but many more times than not, it doesn't.

When a person is really low, it's essential to get a quick form of sugar into them - juice, cake, candy, etc. When a person is high, they need to take insulin. However, when a diabetic is experiencing either of these extremes, they look pretty much the same - the only way to know if the individual is high or low is to do a "test" - prick their finger & take blood.

Anyways, a person who is first aid certified can obviously give a person a glass of juice, they cannot prick a person's finger to do a test, cannot administer insulin, and once the person's unconscious, do not have much time. Beyond that, it is MUCH more dangerous do be low than to be high, and although it's not good to be high, it's really hard to kill someone by giving them more sugar.

So no it's not the absolute best situation, but nothing in first aid is - you're doing the best you can to keep them.. alive, literally until help (ie. ambulance) comes.

So I fully understand where you're coming from, but hope you understand my long explanation - it's harder to explain than I thought!

6. that is absolutely ridiculous! i cant believe that they tell people that! but i guess if someone is seizing it is more likely that they are hypoglycemic but the instructor should have listened to what you had to say. is there anyway to contact the red cross and ask them why its being taught like that and maybe you should request some clarity in the way they teach diabetes treatment. i mean I'm sure they have a customer service line or something. i mean they should be open to suggestions if it could possibly save peoples lives.

7. I also noticed this problem in first aid training, but my instructor was kind enough to clarify.

If a diabetic is having a medical emergency and becomes disoriented or unconscious then it is often safe to assume they are hypoglycemic (have too low blood sugar) and they should be given sugar in the form of juice, chocolate, glucose tablets/syrup, etc.

Even if the diabetic is having an emergency because they are hyperglycemic (too high blood sugar), it is not easy for a first-aider to distinguish the two conditions and they should be given sugar because high blood sugar is not as dangerous as low blood sugar in the short term.

Yes, high blood sugar is bad in the long run, but if its the difference between them lapsing into a diabetic coma or having to take some insulin later, it's safer to give some sugar.

8. I'm a long-time paid Red Cross instructor...

Let's look at this a little differently... what are the different signals of high vs. low blood sugar emergencies?

Here are the signs- which is a sign of which?
- Shortness of breath
- Fruity breath
- Thirst
- Dry mouth
- Dizziness
- Nausea, vomiting
- Changes of consciousness
- Palpitations
- Depression, slowing down, weakness

More importantly- which will you remember a year later with no reference materials?

Next, look at the pros and cons of the sugar treatment (and we don't recommend candy or other 'slow-acting' sugars)...
PROS-
- Saves lives if low blood sugar
- Easy to remember

CONS-
- If victim has too much sugar already, they get a little worse.



Now- what instructors sometimes leave out is that if you have been trained to a different level by someone who has the proper training (such as a diabetes counselor, nursing specialist, etc.) then you should follow that training. I also point out that if you are helping a stranger, that they or their family knows more than you do.

Also, remember the actual name of the class- First-Aid Basics. This is not meant to be anything too deep or complicated- just some basic stuff for the everyday person in everyday situations. Most of us will never use most of the material in the class.
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9. Now if it is too high it could be harmful. They would need insulin then, but it would be okay if it was too low.