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HELP!! DH gave son 26 units instead of 2.6

Discussion in 'Parents of Children with Type 1' started by momof1CWDinohio, Jun 18, 2013.

  1. momof1CWDinohio

    momof1CWDinohio Approved members

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    Please help -- anyone. My son was over 400 for awhile due to an unbolused dinner with my parents tonight (had some lows and pump wouldn't take it). My DH tested ketones (0.0) and changed site. Gave a shot to cover the high and misread the syringe (!!!!!) and gave him 26 units Novolog instead of 2.6. Only realized this about 30 mins ago after giving a number of juice boxes. Called the after hours line and they said give glucagon via syringe and see what happens. He's back up to 125 just now 15 mins later. But 26 UNITS -- am totally scared. What would you do?? Go directly to hospital? I want to but nurse on call said wait.
     
  2. Sarah Maddie's Mom

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    You need to "cover" that many grams of carbs. If his I:C ration is 1:10 by example you need to cover 260g of carbs and get there before the insulin peaks. Depending on his carb ratio and insulin sensitivity that may actually be a much higher #.

    Personally if glucagon has already been given and he's only 125 I would probably want help but if you are already past insulin peak time and you think you can get a ton of fast carbs into him then you may be able to manage alone.

    Sorry to be vague, it's a tricky situation.
     
  3. cdninct

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    All good advice. Keep the carbs coming, be ready to get more help if needed, and good luck!
     
  4. momof1CWDinohio

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    Thank you for your reply! His I:C is 1:12, so that means 312 carbs. Yikes. We probably gave him 70 carbs via juice box and sour patch kids before he fell asleep. Insulin was given @ 9:30pm ET so we are past the peak. And about half an hour ago I gave him 15 units glucagon via SC syringe. He's 162 and slight arrow up now on Dexcom (and blood test 15 mins ago showed G4 and blood meter very close in accuracy). Does the glucagon make up for some of the fast-acting carbs? Since past peak, are we okay? Sleeping next to DS now.
     
  5. momof1CWDinohio

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    Thank you! Dexcom dipping down again and can get no more fast-acting carbs into him. Getting ready to go to hospital.
     
  6. Sarah Maddie's Mom

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    Glucagon raises bg by forcing the liver to dump it's stored glucose into the blood stream. That raises bg but it is the bodies "last" resort and if he were to go low in the near future he would no longer have that emergency supply.

    So since he was high and you got carbs and glucagon into him and it's been 4 hrs you are likely in the clear. :cwds: I'd keep a very close eye still and personally I wouldn't correct anything until morning even if he gets quite high from the glucagon.

    Glad it worked out :cwds:
     
  7. momof1CWDinohio

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    Well, we are here in the ER now because his BS dipped and is now 72 but holding steady. Glad to be here and thankful for your replies!
     
  8. sooz

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    Keep us posted!
     
  9. wilf

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    Not quite clear from your posts exactly when he got the 26 units. But if I'm reading it correctly it was 9:30 pm ET.

    Given that you started the thread after 1 am, the bulk of the Novolog will have acted by then. But a typical Novolog injection has a small "tail" or residual that lasts beyond the 3-4 hours that we are told the insulin is active. A huge injection like this will have had a much longer and stronger tail, which would account for the significant drop you saw between 1 and 3 am despite having given the 15 units glucagon.

    Anyhow I'm glad this seems to have worked itself out. The one thing I wasn't clear about was why not give him another 15 units glucagon at 2 am, instead of going to the hospital?
     
  10. missmakaliasmomma

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    Hoping your son's ok! I I would've went to the hospital too
     
  11. Lisa - Aidan's mom

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    Hope he is ok now; you must have been so worried!
     
  12. Lee

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    How do you draw up 2.6 on a syringe?

    (I am just wondering - I have a hard enough time drawing up .5 a unit, I can't imagine the precision needed to draw up a tenth of a unit.)
     
  13. swellman

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    We routinely calculated and targeted tenths with half unit marking syringes. It's pretty easy to eyeball IMO but I have used syringes for measuring throughout college. My wife did it with no problems.

    Of course, the reality of the dose is hit or miss probably by a tenth or half that.

    EDIT: I'm almost certain if we had delivered 26 instead of 2.6 we would have packed up and went to the ER. There's just no way we could expect to keep BG up and stable. Just the thought of it scares the living daylights out of me.
     
  14. hawkeyegirl

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    Was this your husband's first time giving a shot? I'm not being snarky here. I just can't quite envision how someone who has ever given a shot before could make a mistake of this magnitude.
     
  15. bisous

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    Ugh. Sadly I can see my DH doing this. In his case, it wouldn't be the drawing up that would be the problem, it would be calculating the dosage. When we were very newly diagnosed, DH gave DS 2.5 units instead of .25. Crazy since 1 unit dropped him 400 points!! (DS was little and new to D). While that seems impossibly stupid to me, some people really, really suck at math. Needless to say, pumping was essential for us.

    OP, I'm glad you guys are okay.
     
  16. virgo39

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    I hope all is going well today. I think that would be incredibly frightening--that is a massive amount of carbs, especially at bedtime.

    Once things settle down, you may want to sit down with your DH and try to figure out what went wrong and why (understanding that sometimes people simply make mistakes that seem to have no explanation) in order to avoid other errors in the future.
     
  17. Christopher

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    It happens to the best of us. I remember a few years ago I gave Danielle fast acting instead of her long acting insulin at bedtime. Luckily I check her multiple times at night so I was able to catch it but she was in the 40's and I spent the rest of the night trying to bring her back up and testing her. I can't remember if it was 7 or 12 units of Humalog that I gave, but it was pretty scary. And if I hadn't checked her during the night.............?
     
  18. danismom79

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    Yikes! I remember back in my daughter's NPH/Humalog/Regular days when I mixed all 3 and almost filled the whole syringe. I hope you all made out ok and were able to get some rest today.
     
  19. KatieSue

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    I hope he's feeling better now. How scary.

    We did the same thing once. Her PDM had gone wonky. I went to the school to try and troublshoot. It was during a party and she was lamenting the fact that she couldn't eat all the lovely snacks until I figured it out. So I said just take a shot. I was on hold with Insulet and she calculated the carbs and said I take - can't remember how many but lets say 25 units - so I said sure. Wasn't really paying attention.

    As soon as she'd taken the shot we both realized we were off, way off, way way off. Stuffed her full of all the treats plus juice boxes galore. She ended up fine but scared the bejeebers out of us both.

    A friend of hers took his Lantus dose at dinner one night, only he mistakenly took Novolog instead. They had to stuff a bunch of candy in him, they were at the movies, and fight him down a bit but he ended up fine as well.

    Things do happen but man they're pretty darn scary at the time.
     
  20. hawkeyegirl

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    I think most people who have been on shots for any length of time have done this. And I understand math errors too. I just remember when we were on shots, and there is no mistaking how a syringe looks when it is 2.6 units vs. 26 units. If your child only takes 2.6 units to get down from a 400, you have never, ever, ever filled a syringe up to 26 units. You've probably never put FIVE units in a syringe. I just am not quite understanding how after probably never seeing more than a centimeter of insulin in a syringe, someone out of the blue injects almost a full syringe of insulin into their child. Unless they've quite literally never given their child a shot before.
     

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