🚧 Under construction — VoTechWorks is being built. A free tech program — complimentary, as our commitment to get America working.
voTechWorksGrade 13 · a vocational technology learning center, by urbanicity
newSchoolWorks.com › VoTechWorks › Agriculture, Environment & Public Service › Firefighting / Public Safety › Emergency Medical Technician – Basic (EMT-B) › Lesson 7
AGR-FIRE51-06 · Lesson 7 · 10 clock hours · theory

Medical Emergencies: Diabetic, Toxicological, Behavioral, and Obstetric

Objective. Students will identify the signs and symptoms of hypoglycemia, hyperglycemia, poisoning/overdose, behavioral emergencies, and normal and abnormal childbirth, and select appropriate BLS interventions for each condition.

⚠ Pending professional review

This lesson, its worked examples and its practice questions has not yet been verified by a licensed professional in the field or by a certification or approval body. It is a study draft and may contain errors. Do not use it as instructions for work on a job site or on live equipment. Always follow your instructor, your supervising professional, and current official references and regulations.

VoTechWorks program approval and accreditation are still in progress. Credentials are issued only by the certifying bodies named in each program, after their own exams.

Medical Emergencies: Diabetic, Toxicological, Behavioral, and Obstetric

As an EMT you will encounter patients whose life-threatening conditions are caused by internal chemistry gone wrong, ingested poisons, mental health crises, or the demands of childbirth. Recognizing each category quickly and applying correct BLS care makes the difference between a good outcome and a preventable death.

Diabetic Emergencies

Blood glucose is tightly regulated in healthy individuals. Two common diabetic emergencies move that balance in opposite directions.

Hypoglycemia (low blood sugar) develops rapidly — sometimes within minutes. The brain depends entirely on glucose, so low levels cause altered mental status that can look like intoxication: confusion, slurred speech, combativeness, weakness, diaphoresis (sweating), pale skin, and shakiness. Left untreated, the patient may seize or become unresponsive. Key history clue: a diabetic who skipped a meal or took too much insulin.

Hyperglycemia (high blood sugar, diabetic ketoacidosis — DKA) builds over hours to days. Signs include warm dry skin, fruity or acetone breath, excessive thirst and urination, deep rapid breathing (Kussmaul respirations), nausea, vomiting, and gradual altered mental status.

EMT interventions: For any diabetic patient with altered mental status, use a blood glucose monitor per protocol. If the patient is conscious, able to swallow, and hypoglycemic, administer oral glucose as directed by medical direction. Never give anything by mouth to an unresponsive patient. For hyperglycemia or uncertainty, provide supportive care and transport; IV glucose correction is an ALS skill. Always reassess after any intervention.

Toxicological Emergencies

Poisoning and overdose are broad categories that include ingested, inhaled, injected, and absorbed substances.

Ingested poisons cause nausea, vomiting, abdominal pain, and altered mental status. Corrosives (acids, alkalis) burn the mouth and throat. Identify the substance if possible — bring the container.

Opioid overdose produces the classic triad: pinpoint pupils, respiratory depression, and decreased level of consciousness. Intranasal or intramuscular naloxone is approved for EMTs in most states per protocol; follow your local medical direction.

Stimulant overdose (cocaine, methamphetamine) produces agitation, hypertension, tachycardia, hyperthermia, and potential seizures.

Carbon monoxide (CO) poisoning presents with headache, nausea, confusion, and cherry-red skin (a late finding). Standard pulse oximetry reads falsely normal because CO binds hemoglobin. High-flow oxygen via non-rebreather mask is the essential BLS treatment. Scene safety first — never enter a CO environment without SCBA.

Activated charcoal may be used for certain ingested poisons per medical direction; it is contraindicated for altered mental status, caustic substances, and hydrocarbons. Always consult medical direction before administration.

Safety point: In suspected illicit-drug environments, be alert for fentanyl exposure. Wear appropriate PPE (nitrile gloves minimum; consult your agency's exposure policy). Do not eat, drink, or touch your face on scene.

Behavioral Emergencies

A behavioral emergency exists when a patient's actions pose a danger to themselves or others or are so abnormal that intervention is required. Causes range from psychiatric illness to hypoglycemia, hypoxia, head trauma, substance use, and medications — always rule out medical causes first.

Signs and symptoms: agitation, threatening behavior, hallucinations, extreme anxiety, suicidal ideation, violent outbursts, or unresponsiveness to reality.

EMT approach: Ensure scene safety — law enforcement should secure the scene before you enter if violence is possible. Use a calm, non-threatening tone. Keep hands visible, maintain a safe exit path, never restrain a patient alone, and document all findings. Patients retain the right to refuse care if they have decision-making capacity; consult medical direction and law enforcement when involuntary transport is needed. Use restraint only as a last resort and per protocol; always monitor restrained patients closely for positional asphyxia and airway compromise.

Obstetric Emergencies

Normal delivery: Labor progresses through contractions that increase in frequency and duration. When crowning occurs (baby's head visible), delivery is imminent. Position the mother supine or semi-reclined, apply gentle pressure to the baby's head to prevent explosive delivery, and support the head as it emerges. Check for a nuchal cord (cord around the neck); if loose, slip it over the head. Suction the mouth then nose with a bulb syringe after head delivery. Support the body as it delivers, clamp and cut the cord per protocol, and keep the newborn warm by drying and covering.

APGAR-related newborn assessment: Evaluate appearance (color), pulse, grimace (reflex), activity (muscle tone), and respiration at one and five minutes. A vigorous newborn cries, is pink (or central pink with peripheral blue), and has good muscle tone. A newborn who does not breathe spontaneously requires stimulation (drying and rubbing the back), repositioning, and BVM ventilation if not improved.

Complications:

Safety points for delivery: Use full body-fluid isolation PPE: gloves, eye protection, mask, and gown. Sharps (cord clamps, scissors) must be handled carefully and disposed of in a sharps container.

Key terms8

HypoglycemiaAbnormally low blood glucose level causing rapid neurological symptoms such as altered mental status, diaphoresis, and weakness; treated with oral glucose in conscious patients able to swallow.
Hyperglycemia / Diabetic Ketoacidosis (DKA)Elevated blood glucose resulting from insufficient insulin; characterized by Kussmaul respirations, fruity breath, warm dry skin, and gradual altered mental status developing over hours to days.
NaloxoneAn opioid antagonist medication that rapidly reverses opioid-induced respiratory depression; may be administered by EMTs per local medical direction and protocol.
Activated CharcoalA binding agent given orally for certain ingested poisons to reduce absorption; contraindicated in altered mental status, caustic ingestions, and hydrocarbon ingestion.
Positional AsphyxiaSuffocation resulting from a body position that restricts breathing; a critical risk in restrained patients who must be continuously monitored.
CrowningThe stage of labor when the baby's presenting part (normally the head) is visible at the vaginal opening, indicating imminent delivery.
Prolapsed CordAn obstetric emergency in which the umbilical cord presents ahead of the baby, risking cord compression and fetal hypoxia; treated by manually elevating the presenting part and immediate transport.
Kussmaul RespirationsDeep, rapid, labored breathing pattern associated with metabolic acidosis, classically seen in diabetic ketoacidosis as the body attempts to exhale excess carbon dioxide.
In class: Case study jigsaw: class is divided into four groups, each assigned one emergency category (diabetic, toxicological, behavioral, obstetric); each group reads the Brady textbook chapter, creates a one-page summary of key signs/symptoms and EMT interventions, then teaches their section to the class. · Scenario card drill: instructor distributes 20 scenario cards; students individually write the emergency type, critical findings, and priority interventions for each, then compare answers in pairs. · Emergency childbirth simulation using a birthing manikin: students assist an uncomplicated delivery, manage the newborn (drying, warming, APGAR-related assessment), and recognize when complications (breech, prolapsed cord) require immediate ALS/transport decision.
Materials: Brady EMT textbook, birthing manikin with delivery kit (bulb syringe, clamps, drapes), blood glucose monitor trainer, activated charcoal bottle (training prop), scenario cards, whiteboard
Check: 20-question written quiz covering all four emergency categories; pass = 70%; birthing simulation checklist: student must complete all critical delivery steps including newborn airway management with no critical failures for sign-off.

Practice check8

Answer each question, then check it. Nothing is recorded; this is your own practice.

NREMT EMT – Medical Emergencies
1. A 34-year-old known diabetic is found confused and diaphoretic. Her skin is pale and she is shaking. Her blood glucose reads 48 mg/dL. She is conscious and able to follow commands. Which intervention is most appropriate?
NREMT EMT – Medical Emergencies
2. You respond to a patient with gradual onset of altered mental status over two days. He is breathing deeply and rapidly, his skin is warm and dry, and bystanders report a fruity odor on his breath. Which condition does this presentation best describe?
NREMT EMT – Medical Emergencies
3. A patient is found unresponsive with pinpoint pupils and slow, shallow respirations of 6 per minute. Which treatment is the highest priority?
NREMT EMT – Medical Emergencies
4. A household with a malfunctioning furnace has three family members complaining of headache and nausea. Standard pulse oximetry on all three reads 98–99%. Which action is correct?
NREMT EMT – Medical Emergencies
5. During a behavioral emergency call, the patient becomes verbally threatening. Law enforcement has not yet arrived. What is the EMT's first action?
NREMT EMT – Medical Emergencies
6. You are monitoring a restrained behavioral emergency patient in the back of the ambulance. Which complication must you continuously assess for?
NREMT EMT – Medical Emergencies
7. During an out-of-hospital delivery, you observe the umbilical cord protruding from the vaginal opening before the baby's head. What is the correct EMT intervention?
NREMT EMT – Medical Emergencies
8. A newborn is delivered and does not cry. She is limp and appears pale-blue centrally. After drying, warming, and stimulating her for 30 seconds, she still has not established adequate respirations. What is the next appropriate action?
Record this lesson on my transcript. Sign in with your key and enrollment email to record lessons (enroll free if you have no key). This page stays open to read and practise.
← Previous lessonProgram planNext lesson →