Give her a quick-acting sugar, such as fruit juice or candy, and then tell the doctor. Her symptoms fit a hypoglycemic reaction, which means a reaction from low blood sugar. Many eye offices keep fruit juice, sugar cubes, or candy on hand for exactly this event. Because she is alert and able to swallow, sugar by mouth is safe and it works within minutes. Reporting to the ophthalmologist right after is part of the same step.
Learn the stages so you can act early. Low blood sugar first makes a patient weak, sweaty, shaky, or dizzy. Next may come numb lips, blurred or changed vision, confusion, mood change, or irritability. If nothing is done, the patient can have a seizure or fall into a coma. Blood sugar swings with food eaten, exercise, medicines, and stress. A long wait in a busy office brings both stress and a missed meal. Ask your ophthalmologist ahead of time which comes first in your office, first aid or notifying the doctor, so you never have to guess. Many patients with diabetes carry their own sugar source and know how to treat themselves, so ask her what she usually uses. Prevention helps too. Book patients who use insulin at times that do not clash with their meals. Offer a snack or juice when a test or a wait runs long. Warn her too that a long dilated wait can pass a mealtime without anyone noticing.
Remember the short version: awake and swallowing means give sugar, then tell the doctor. Recognizing and treating low blood sugar belongs to the COA content area on ophthalmic patient services and education.
Incorrect Answers
- A. Lying her on the floor treats fainting, not low sugar. It delays the sugar she needs and may frighten her.
- B. Water has no sugar in it. Vital signs can wait until she has swallowed juice or candy.
- D. An alert patient who can swallow usually recovers in the office. Sending her out untreated risks a seizure on the way.
Testing Pearls
- Low blood sugar starts as weakness, sweating, shakiness, or dizziness.
- Later signs include numb lips, vision change, confusion, then seizure or coma.
- For an alert patient, give fruit juice, sugar cubes, or candy, then notify the doctor.
- Blood sugar is affected by food, exercise, medicines, and stress.
- Schedule insulin-dependent patients away from their mealtimes.
References
- American Academy of Ophthalmology. Ophthalmic Medical Assisting: An Independent Study Course. Chapter 16, Patients With Special Concerns.
