I was just wondering, if a patient comes to your hospital and part of their history is diabetes but that is not part of their primary diagnosis, do you still check their fingerstick? I just found out that this is not protocol at my hospital (I don't work in the ED, but a close friend does). She said that they will sometimes look at the blood glucose level when a blood panel is drawn, but unless the patient is admitted for something diabetes related they don't check fingersticks. Well this caused a problem for me the other day. I had a patient admitted for PNA who was also diabetic. While in the ED, he had a sandwich and a few snacks (he's generally well controlled at home, knows his diet). No one ever bothered to check his fingerstick, so when I checked it at night it was 426!! At home he takes a large amount of NPH BID, but had not had any that day. Of course in the ED you can't just waltz in with your own meds and start giving yourself insulin, so this guy just went ahead and ate not knowing his fingerstick since no one checked. (I know he could have asked someone, but when your starving and can't get anyones attention, you can't help it) So, in addition to trying to get his blood sugar back to a normal level, I was also going back and forth with the docs because they had the orders all wrong for his insulin compared to what he takes at home. Anyone else experience situations like this in their hospital? Thanks for the input!!
