Wednesday, 2 May 2012

Sky1 "Touch": Irresponsible insulin injection!

There is a new series on Sky1 at the moment, call "Touch". As a series it is not bad, very watchable. It happened to be on TV last night.

During the episode the main character (Kiefer Sutherland) finds someone unconscious on the floor. He called emergency services - good - right thing to do.

But then he used the man's phone to call one of his friends, who then said "He is diabetic" and directed him to get insulin from the fridge and inject the man - within seconds he woke up and was well - hero!

This is seriously irresponsible. This is prime time TV and watched by a lot of people.

My daughter already had this misconception. She was likening my insulin pen to an epipen used to treat those with sever allergic reactions in an emergency. She had seen that on TV.

Diabetes means that your body does not produce enough insulin, and (once medications are no longer effective) a diabetic will take insulin. A diabetic taking insulin has two main problems because we are using injections to replace what a healthy body does normally:-

1. High blood sugar. This can happen if we forget to take insulin or don't take enough, or even just eat too much. This makes you thirsty, tired, even sleepy. You don't feel too well. It is not good for you in the long term, and untreated diabetics can suffer a number of nasty side effects of long term high blood sugar after many years. Eventually it will kill you. It does not make you pass out or put you in a coma!

2. Low blood sugar. This happens if you take too much insulin, or simply don't eat enough. It makes you irritable and disorientated. It can be confused with being drunk even. It can cause you to pass out and go in to a diabetic coma. This is bad, very bad, and can kill you quickly (within hours).

So, what do you do if you find a diabetic that is passed out? The last thing you do is give them insulin! If you do - you are probably murdering them.

The best advice is call emergency services. If you know the person is diabetic, tell them. They can advise you if there is anything you can do.

Generally, if you can wake them, getting them to eat or drink something with sugar in it is probably going to help. One issue with a diabetic that has been drinking is that they seem drunk - and that is usually "treated" by letting them sleep it off. That is not so good if they have low blood sugar and can mean they never wake up.

I am not a doctor, just a diabetic. But please: don't try administering drugs because you saw it on a TV show.

Of course, on the TV show, the character is given an injection of insulin in the arm with no thought to what dose to give, or which sort of insulin it is. I currently take a slow acting insulin that takes effect over around 24 hours. Even if I did have high blood sugar, an insulin injection of that type would not have an instant effect. But even if I had high blood sugar, a large dose of fast acting insulin could cause the opposite effect quite quickly and put me in to a coma.

There are enough people with diabetes around who should have been able to spot this silly mistake during the shows production. Why was this aired like this?

12 comments:

  1. While he did say insulin, the packaging looked very similar to the injections my girlfriend keeps in the fridge. They are loaded with glucose! That would have been exactly the right thing to do!

    ReplyDelete
  2. The moment you know *anything* about the subject matter it spoils the TV show because you know how bullshit it is.

    I've often shouted at the TV because some programme is misusing computer terminology. I bet the average doctor/nurse simply can't watch Casualty. And I can only imagine what the Aliens think :p

    Luckily in this case if you phone the ambulance (which should be your first response anyway) then they'll normally stay on the phone and tell you exactly what to do and what not to do. I've been through similar when doing voluntary work in Manchester, and they were giving advice and asking about the state of the patient for a good 15 minutes before the ambulance turned up.

    ReplyDelete
    Replies
    1. Oh, I agree, but knowing that McGee on NCIS cannot really trace an IP address the way he does is not dangerous. "Educating" the general public that giving an insulin injection to an unconscious diabetic is a good idea could kill someone.

      Delete
    2. "Oh, I agree, but knowing that McGee on NCIS cannot really trace an IP address the way he does is not dangerous."

      Except to free speech, as it generates unrealistic expectations of what can be done to stop *insert undesirable activity of the week*, and hence stupid, unworkable, dangerous laws.

      Delete
    3. There are reports that politicians in some parts of the world believe NCIS / CSI / .. a bit too much and expect the police to do the things as seen on TV, leading to dissapointments. So yes, what people see on TV can cause them to believe it (oh no!)

      Delete
  3. @Dave is correct, We also have Diabetic pens in the fridge which are glucose in case of such an emergency.

    Most Diabetics will have some form of warning be it a bracelet, locket, or a card in their wallet. It doesn't look good rifling through an unconscious person's valuables and wallet but it can save their life!

    Also grab their phone as it may have a warning on the unlock screen, or a sticker on the back or search their contacts for ICE (In Case of Emergency) which should have details.

    Also take a peek behind their front door - there may be a sticker with details.

    Also take a look in their fridge - we have a film capsule with details in marked with a green cross on a white background. AFAIK Paramedics are trained to look for these?

    (what will we do when all the old film capsules are gone? Use the wrapper from an SD card?)

    Final thought:

    If you give a diabetic insulin you can kill them
    If you give a diabetic sugar/glucose you won't hurt them but may save them

    ReplyDelete
    Replies
    1. Interesting that people have glucose injections - not seen that myself, but the point is that the on TV they said "insulin".

      Thanks for the extra information on this.

      Delete
  4. @SimonF In the UK you can save yourself a film canister by getting a specially designed plastic container free. See http://www.southcentralambulance.nhs.uk/self-care/helpushelpyou/messageinabottle.ashx

    All first responders in the UK are trained to look for these. Patients are advised to put the supplied sticker on the inside of their front door (we look there first then go hunting for the fridge).

    It's also important to let people know around you of your condition, particularly outside of your home, and telling them about the warning signs they may pick up on. Early intervention can make a huge difference.

    While I agree with Adrian, there's new technology risks too. Patients are being given bluetooth controlled insulin pumps. I'd be willing to bet money that they're not as secure as I'd like them to be.

    ReplyDelete
  5. @Nick there has been loads of articles on slashdot and theregister about insulin pumps being hacked wireless to deliver their entire contents over a few mins with no warning to the user, Scary huh?

    ReplyDelete
  6. I might prefer that TV dramas didn't make an effort to be medically/legally/technically accurate - it might give the impression that anyone should take any sort of advice or example from them :>. For example, whoever writes Casualty/Holby might raise Barnett v. Chelsea & Kensington every time a doctor-actor is accused of killing a terminal patient.

    The First Aid lesson I've been taught is "don't administer any medication whatsoever to any stranger". No matter how clever I think I am, I do not use my initiative to override this. Medical professionals have the training and experience that I don't. I am likely to kill someone.

    (But I should be prepared amongst people i know - not just for allergies/diabetes, but carrying the venerable aspirin for those at risk of heart attack.)

    ReplyDelete
  7. I might prefer that TV dramas didn't make an effort to be medically/legally/technically accurate - it might give the impression that anyone should take any sort of advice or example from them :>. For example, whoever writes Casualty/Holby might raise Barnett v. Chelsea & Kensington every time a doctor-actor is accused of killing a terminal patient.

    The First Aid lesson I've been taught is "don't administer any medication whatsoever to any stranger". No matter how clever I think I am, I do not use my initiative to override this. Medical professionals have the training and experience that I don't. I am likely to kill someone.

    (But I should be prepared amongst people i know - not just for allergies/diabetes, but carrying the venerable aspirin for those at risk of heart attack.)

    ReplyDelete
  8. The "glucose" injection will be Glucagon. In the UK its usually supplied as a HypoKit and is kept in the fridge. It's not actually glucose, but it does cause glucose stored in the body to be mobilised and therefore increase the patient's BM. The other thing that is available is HypoStop Gel which is basically glucose syrup in a tube, designed to be rubbed around the gums of someone going hypo, but not when they are completely unconscious as they might choke on it.

    ReplyDelete