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Please carry glucagon, you never know...

Discussion in 'Parents of Children with Type 1' started by missmakaliasmomma, May 9, 2014.

  1. Megnyc

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    Yes, but the OP said that the fainting and glucagon happened at 11:00. I agree that the most likely situation was the glucagon given with the BG of 31, 39 minutes after the pre bolus. That still doesn't explain why the nurse and OP think the fainting/glucagon happened at 11.
     
  2. wilf

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    Better to not rush to judgements like this, when there are simpler possible explanations.

    I think there was just a prebolus (which included insulin for dessert) given way too far in advance of the child actually getting the dessert. Effectively a 38 pound girl was given an insulin dose (with no covering carbs) of say 1.5 units when her BG was 96. It's no surprise she collapsed 40 minutes later - that dose could take down my daughter within an hour under similar circumstances. The nurse then measured to make sure it was from low blood sugar, saw the 31, gave glucagon.
     
  3. wilf

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    If you go through every post in this thread, you'll find the details initially posted were updated..
     
  4. mmgirls

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    is there a snack before lunch that is covered? Should there be IOB at lunch?

    The 3.5 units would have been full coverage for 56 carbs and not reverse correcting back to target.
     
  5. Darryl

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    I think an error was made in reporting the BG readings but the theory that she induced a low for job security seems a little far fetched. My guess is that the nurse gave her the glucagon as a reaction to her passing out, then realized later that she needed to document the use of a glucagon with a BG reading, and came up with low number of 11 without realizing that such a number is below the LO threshold of the meter. Aside from whatever the reason for the apparently impossible BG reading, she did give glucagon upon seeing a T1 child lose consciousness which is better service than some kids might get at school. We should wait for all of he facts...
     
  6. wilf

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    I've been wondering about this too. 56 carbs at a carb ratio of 1:16 is 3.5 units. Where was the negative-correction for being 24 points below the target level of 120?

    Given the ISF of 120, 0.2 units should have been taken off to give a prebolus of 3.3 units. Not a big deal in the overall scheme of things, but something to note.
     
    Last edited: May 14, 2014
  7. mamattorney

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    I guess I am going to jump on the "something's fishy" bandwagon, too.

    Just an example, and as a lawyer myself, I know some would see me as part of the problem, but unconscious kid + diabetes + school seems like it should equal a call for paramedics to me, even if it's just precautionary.

    I think it would also trigger some sort of medical emergency incident report for the dirstict. The school should be confirming with witnesses that she actually ate her lunch, that the nurse did everything exactly like your daughter's medical plan said to do, etc.

    Schools are not immune from being sued and I find it hard to believe that there isn't more of a paper trail associated with this situation. You should ask.
     
  8. swellman

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    The internet will ultimately solve this case ...
     
  9. caspi

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    Yes. This.
     
  10. mmgirls

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    that's funny.
     
  11. Melissata

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    I'm sure Meg is correct, but you could also call the meter company to verify this. You could start out your investigation by saying you were wanting to find out if the meter was accurate with such a low reading. There is no way I would want a nurse with my child that allowed this to happen and is so obviously lying to cover something up.
     
  12. mmgirls

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    I am not sure if this where to happen in my school if any additional paperwork would e required "if" everything is as the nurse stated.

    If I have a kiddo in my school with an known medical condition that could cause fainting/unconscientiously /seizure and have medical orders for use of a medication and I have an active medical license. Then that normal everyday paperwork with addition of "nurses" note would probably be it. This from the Nurses end of things, that is.

    But if I were the administration of the school, I think it would behoove them to have their own rendition "incident/accident" report to be done, but some might believe that the nurse did "her " job and everything is good.
     
  13. mmgirls

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    how have her numbers been since all of this?
     
  14. missmakaliasmomma

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    Basically normal for with the exception of spikes after lunch since she hasn't been prebolused since Friday.

    Snack is after lunch. I doubt there's usually iob before lunch, maybe a tad.

    I agree, it was a good thing to do, a good reaction but I HATE being lied to more than anything. I'm easy going, she could've just told me she fainted, gave glucagon and that's it. I tell everyone "better safe than sorry"... I'd rather correct a high than see a low
     
  15. shannong

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    I haven't read all the posts, but yes meters definitely store the Lo readings. Just tested the One touch and freestyle by touching the strip to water, got LO readings and yes, they were both stored. I was curious about this too.
     
  16. MomofSweetOne

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    How soon after the glucagon did she call you? I'm just wondering whether she was so rattled with having a child under her care go unconscious that the 11 she gave you was actually the time and she was still in fight/flight stress mode when she called and confused things? Just because someone is an RN doesn't make them immune to the stress such a frightening situation would create. I know that I frequently misquote numbers that I think I remember, and that's without glucagon being involved.

    As an earlier poster said, this should get the CGM to be automatically approved: a daytime low unfelt by the child resulting in unconsciousness with a 1:1 RN on duty monitoring her for lows. If that isn't an automatic rubber-stamped case for necessity, I don't know what is. And hopefully with the Dexcom monitoring her, you won't have to face this again.
     
  17. kt_mom

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    This is what I was thinking, since it was around 11:00. Maybe the nurse isn't lying, she just confused the numbers because of the stress/fear involved in the situation. It should be easy to verify that she did in fact faint and with that I would just be thankful the nurse administered the glucagon.
     
    Last edited: May 16, 2014
  18. Sarah Maddie's Mom

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    Just my 2 cents. If my kid was given glucagon without legitimate cause I'd be furious. And any nurse who can't tell the difference between a faint and a seizure, well, I wouldn't want that person attending to my kid. Jmho.
     
  19. hawkeyegirl

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    And keep in mind, this is an RN. Her training should have taught her NOT to panic in a medical emergency - this is her job, for heaven's sake. It's not like she was a teacher giving glucagon. As a medical professional, she should be able to reconstruct and document the sequence of events accurately and truthfully.
     
  20. kt_mom

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    I'm not a nurse, so I can't say, but how would the nurse know if the child fainted because of low blood sugar or because of something else? They told us in the hospital that if DD was ever unconscious we should administer the glucagon first and ask questions later. That's the instructions I've given everyone who cares for her as well. Unless they see the baseball hit her in the head then they should assume unconsiousness is blood sugar related and give her glucagon.

    There was a 31 in the meter right? So we know that the child was dangerously low at some time during this whole event.

    I guess I just don't understand why we can't give her the benefit of the doubt in having tried to give the best care to the child and that maybe she just mixed up the numbers. Why does it have to be some nefarious plot to harm the child and keep her job or flimsy lie to cover her own butt? Or maybe there is some back story to this nurse I'm not aware of.

    I realize I am new to all this, and maybe there is something you all know that I don't that leads everyone to believe that the nurse is lying and didn't just mix up the numbers. But since the number she gave corresponds to the time the first thought I had was that she mistakenly said the bg was 11 when she was thinking that all this transpired around 11.
     

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