Extremely low blood pressure and blood sugar

[MsVic]

My husbands blood pressure went so low that he was totallyout of it, non coherent at the restaurant.Also broke out into full body sweat.  Called 911. Meanwhile could not find pulse, too faint. He wears nitro patch. Cronic heart patient with bypass several years ago and diabetic. I gave him a nitro tab and that seemed to bring him back to me. Shortly thereafter paramedics arrived.
What should I have done? I know CPR for heart stop. But what do do when extremely low blood pressure and blood sugar?

Thank you.

[CCF-M.D.-MJM]

Hi Ms. Vic,

That is a very difficult situation for anyone to be and in and I hope you are doing emotionally well.

If the blood sugar is low, we usually will give glucose through an IV if one is available.  It is also ok to put a lot sugar in his mouth -- just like a diabetic would eat something to get his sugar increased if they were low.

If I am in the field and someone has low blood pressure yet they are wake and able to talk, I would not do CPR.  Wait for the paramedics to come and check his heart rhythm.  It is true that there are some heart rhythms that can cause low or no blood pressure.  If he has an implantable defibrillator, this device serves as his protection from dangerous arrhthmias.  If not, paramedics have a  portable form of this.

If it is symptomatic low blood pressure in the setting of no arrhythmia, often laying down and raising the feet will improve the symptoms.  If he is any chest pain, giving a nitroglycerin can help.  If he does not have chest pain and his symptoms are caused by low blood pressure, nitroglycerin may cause him to pass out but should not do long term harm.

It sounds like you were in a tough situation and you did what you could at the time.  I hope you and your husband are doing well.  Good luck and thanks for posting.

[moosejuice]

I dont really know too much abaout this but if it was in any way caused by low bllod pressure then nitro would have made it even lower and made it worse.

[anacyde]

Hi there.  

As someone who struggles with reactive hypoglycemia, I really had some serious problems during my pregnancies, with my blood sugar dropping as low as 42.  Sometimes even after I started pumping sugar (for rapid rise) and protein (for sustaining the rise and preventing a crash) it would still be a major struggle for hours, sometimes days, to balance everything back out again.  It was a mess, and a frightening one at times.  The drops seemed to come out of nowhere, even when I checked it fairly often and did my best to make sure I followed the diabetic diet.

A couple of things I always had with me in case of an emergency:

1. A cell phone.
2. Peanut butter crackers.  Peanut butter was a lifesaver.
3. Juice, if possible.  I found that carrying around a mini bottle of Gerber baby juice worked real well.  It's portable and it doesn't have to be refrigerated until opened.  Apple has a lot of sugar.

If your husband is diabetic, he should always have an emergency snack.  Most people I know with diabetes don't, thinking they probably have time to get something if they need to.  Personally, I rarely had time once I became symptomatic, so I didn't risk it.  There are also over the counter glucose tablets, but I hated those.

During hypoglycemic episodes, my blood pressure would drop as low as 80/45, and my pulse was faint and slow.  I would also shake, sweat and become extremely dizzy and jittery.  In fact, irritability or anxiety were usually early cues that I better eat.

Hope all my rambling helped.  Hope everything turns out okay.

[bama jane]

are you diabetic?  I was told once I had hypoglycemia after 6 hour blood sugar tests but then new doc said anyone could have hypoglycemia so now I am confused

[anacyde]

No, I am not diabetic.  Have plenty of it in my family, but I've personally never gotten my sugar above 146 (and that was after two strawberry smoothies and a load of mexican food, lol).  My problem has always been just the lows, so they call it reactive hypoglycemia.  I apparently dump too much insulin or something.

[Gabby46]

What treatment, if any, are you receiving for the reactive hypoglycemia.  I have regular hypoglycemic and my reactions seem to worsen into reactive hypoglycemia type symptoms when I take blood pressure meds.  I am watching my diet and that helps but I wondered if there is some other treatment available. Thanks