Colorado Kids With Diabetes | Just another WordPress site



Emergency Action Plan for PUMP: Glucose Monitoring TreatmentGoal: Return Student to target range as quickly as possible without complications.15316202095500PHOTO:STUDENT: FORMTEXT ?????DOB: FORMTEXT ?????GRADE/TEACHER: FORMTEXT ??????TREATMENT PLAN: Low Blood Glucose (Hypoglycemia): Below FORMTEXT ????? mg/dlCauses: Too much insulinToo much exercise High excitement/anxiety Too few carbohydrates eaten for the amount of insulin givenIf you see this:Follow this: ACTION PLANSigns of Mild Low Blood Glucose(STUDENT IS ALERT)HeadacheSweating, paleShakiness, dizzinessTired, falling asleep in classInability to concentratePoor coordinationOther: FORMTEXT ?????Responsible person accompany student to health room or check blood glucose on siteCheck blood glucoseIf less than FORMTEXT ????? mg/dl, give one of the following sources of glucose: ~15gms for fast-acting sugar (student < 5 y.o. give 7.5gms (Checked are student’s preferred source but if not available any of these may be used) FORMCHECKBOX 2-4 oz. Orange or other 100% juice FORMCHECKBOX 2-4 glucose tablets FORMCHECKBOX 4-6 oz. sugar soda (not sugar-free) FORMCHECKBOX 6-9 Sweettarts candies FORMCHECKBOX 8 oz of milk FORMCHECKBOX Other: FORMTEXT ?????4. After 10-15 minutes, re-check blood glucose Repeat giving glucose & re-check if necessary until blood glucose is > FORMTEXT ????? mg/dl. Do not give insulin for the carbs used to bring up glucose level (Do not put these carb grams in pump) FORMCHECKBOX Follow with a 15gm snack(do not give insulin for these carbs) OR At lunchtime/mealtime, after blood glucose is within target range, send the student to lunch/meal. After eating, enter recovered blood glucose level and grams of carbs eaten into pump and use the pump calculator to determine amount of insulin to be given (unless otherwise indicated on Provider orders).Notify parent/guardian & school nurse Comments: FORMTEXT ????? Signs of Moderate Low Blood Glucose(Student has decreased alertness)Severe confusionDisorientationMay be combativeCheck blood glucoseKeeping head elevated, give one of the following forms of glucose:1 tube Cake Mate gel or instant glucose gel applied between cheek and gumAfter 10-15 minutes, check blood glucose againRe-treat if necessary, until blood glucose is > FORMTEXT ????? mg/dl, Follow with 15gm complex carb snack (do not give insulin for these carbs)Suspend/disconnect pump. Notify parent/guardian & school nurseComments: FORMTEXT ????? RESUME pump operation once in target rangeSigns of Severe Low Blood GlucoseNot able to or unwilling to swallowUnconsciousnessSeizureGIVE NOTHING BY MOUTH!Call 911, activate Emergency response, place student on their side, CHECK BGIf personnel are authorized give Glucagon, prescribed dose: FORMTEXT ????? mg(s) Intramuscular OR Give BAQSIMI (3mg): spray in one nostril Suspend/disconnect pump & send pump to hospital with parent/EMSRemain with student until help arrives. Notify parent/guardian and school nurseComments: FORMTEXT ??????Treatment Plan: High Blood Glucose (Hyperglycemia) Blood Glucose above FORMTEXT ????? mg/dlCauses:: Illness Underestimated carbohydrates and bolus Hormonal Changes Increased stress/anxiety Insulin pump not delivering insulinSigns of High Blood Glucose(STUDENT IS ALERT)Symptoms could include:Extreme ThirstHeadacheAbdominal PainNauseaIncreased UrinationLethargicOther: FORMTEXT ?????Note: If on a pump, insulin may need to be given by injection – Contact school nurse & parent.Allow to carry water bottle & use rest room unrestricted.Provide blood glucose correction bolus per pump calculator. All blood glucose levels should be entered into the pump for administration of pump-calculated corrections unless otherwise indicated on the provider orders.Notify parents and school nurse if BG > 240mg or FORMTEXT ????? as indicated on provider orders. If blood glucose > target range but less than 350mg/dl, give correction as indicated by pump calculation, and recheck in 2 hours. Then after rechecking, if blood glucose is still >300, ?check ketones, contact the school nurse/parent regarding giving insulin by injection as this may indicate pump/site malfunction (use pump calculator for dosing) and notify parents for site change (to be changed by parent/guardian/independent student). Contact the health care provider for one-time order if unable to use the pump calculator for insulin dosing or correction dosing ratio is not provided on orders.If blood glucose > 350 mg/dl once, ?check ketones. If urine ketones are moderate-large or blood ketones > 1.0, give insulin by injection (can use pump calculator to determine bolus) and set change by parent/guardian or independent student.? If ketones are negative, give an insulin bolus via pump and recheck in 1-2 hours. Then if the blood glucose continues to be > 350mg/dl, contact the parent to come to school for set change and to give insulin correction (can also be done by the independent student). If unable to reach parent then school nurse will contact health care provider for one-time orders.Encourage to drink water or DIET pop (caffeine free): 1 ounce water/year of age/per hourContact the school nurse for Exercise Restrictions and School Attendance per Standards.If student’s BG level is >350 mg/dl & symptomatic (illness, nausea, vomiting) - notify school nurse & parent immediately. Student must go home to be treated/monitored by ments: FORMTEXT Note: Parent Signature: FORMTEXT ?????Date: FORMTEXT ?????School Nurse Signature: FORMTEXT ?????Date: FORMTEXT ????? ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download