You notice a boat in front of you driving erratically, weaving in and out, and it ends up running aground. The captain is screaming profanities at everyone and appears drunk.

Upon impact he cut his head and is bleeding. As you get closer, you notice the captain is sweating like crazy and breathing heavily. You smell what appears to be a boozy smell of alcohol, but you do not see any bottles or alcoholic beverages. The captain’s speech is slurred.

Is this captain drunk? It might seem that way, but there’s another possible condition.

As a firefighter EMT, I ran numerous calls on people who were acting drunk only to find out they were diabetic and their blood sugar was dangerously low. It’s hard to tell if someone is drunk or has low blood sugar.

The primary rule in a first-aid emergency is “When in doubt, call for help.” On land or at sea, if you are not sure of the severity of the emergency, call for help.

Until help arrives, look for medial alert jewelry, especially around the wrist and neck. Look for prescription medications, medical cards, or insulin syringes.

You should also look at the patient’s vital signs, check their glucose levels and blood pressure, and report these to your medial provider. 

The World Health Organization defines diabetes as a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar.

Hyperglycemia, or raised blood sugar, is a common effect of uncontrolled diabetes and, over time, leads to serious damage to many of the body's systems, especially the nerves and blood vessels.

More than 220 million people worldwide have diabetes, nearly 26 million people in the United States. In 2005, an estimated 1.1 million people died from diabetes.

The good news is that a healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay the onset of diabetes.

Recognizing diabetic emergencies

If the person is aware of their condition, they may be able to tell you what is wrong and how you can assist them. However, they may be unaware of the disease or symptoms may have progressed to the point of confusion.

Some signs and symptoms may include dizziness, drowsiness, rapid breathing, lack of coordination, rapid pulse, sweating though the skin is cold to the touch, weakness, shaking, headache, irritability, bizarre or combative behavior, and nervousness.

And they may have a fruity odor to their breath.

If you know that a person is diabetic and he or she is experiencing symptoms and they are conscious, give them something to eat or drink that contains plenty of simple sugar, such as candy, fruit juice, honey or non-diet soda.

If the person is suffering from low blood sugar, or hypoglycemia, the sugar will help within minutes. If the person is feeling ill because of high blood sugar, or hyperglycemia, he or she will not be harmed by the extra sugar but you must make arrangements to get them to professional medical care as soon as possible.

In the case of untreated hyper or hypoglycemia, permanent impairment, coma and death can occur.

If the person is unconscious, place them into the recovery position, on their side, monitor their breathing and call for help. The doctor will most likely instruct you to obtain a complete set of vitals, including measuring their blood glucose level using a glucometer. 

The doctor may then advise you to administer Glucagon. It is used when seizures occur in an insulin user who is unable at that point to help themselves or if they become unconscious. Glucagon will facilitate the release of stored glucose back into the bloodstream, thus rapidly raising blood glucose levels.

About the Author

Keith Murray

Columnist

Keith Murray, a former Florida firefighter EMT, is the owner of The CPR School, a CPR, AED and first-aid training company that provides onboard training for yacht captains and crew. Contact him at +1-561-762-0500 or keith@theCPRschool.com.