Frank Arnold asked :
-> To any how may help,
-> I'm taking an E.M.T. Intermediate class and the new state guide lines
-> are out and they include something that the instructor has not seen
-> before it is worth extra credit for me if I can find out something
-> about Hyperosmolar Hyperglycemia Non-Ketotic Coma (HHNK) I really
-> need to find out the Pathophysiology of this.  I also need
-> Preciptating factors, Sighs and symptoms, and management.  But any
-> help on this topic would be greatly appreciated.  Thank you in
-> advance. Frank Arnlold EMT-B
    HHNK is a medical emergency occurring in patients with Type II
diabetes, where there is enough insulin produced to avoid diabetic
ketoacidosis, but not enough to prevent severe hyperglycemia, diruesis
and severe fluid depletion.
    S/S : somnolence, coma, seizures and aphasia. The immediate therapy
is to administer fluids intravenously, 6-20 L maybe needed within first
24-48 hours. 0.9% or 0.45% normal saline is used, depending on the
degree of dehydration. Regular insulin is given IV to reduced
hyperglycemia and blood sugar levels are monitored. 
 
    Not being an EMT, I don't know what the guidelines for field
management are, but I hope this helps.
 
Lou, RN
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