Do any of you have diabetic students who use Dexcom?
I have a sixth grader using it and it's pretty cool! It's continuous sugar monitoring of the interstitial fluid. The student has permission to carry their phone and the app sends an alert to the cell phone when blood sugar is too high or low. It sends alerts to her parents' phones. So they've called me once or twice to say "Hey we noticed the sugar was reading low, is the student in the office?" and then I call the student down to use a glucometer and monitor until BS is in range.
Because it's continuous, it shows overnight trends too and give a projected A1C (of course it doesn't replace blood draws).
I guess the nurse who was here before me also got alerts on her phone for during the school day, but I don't think I want to be getting alerts. I wonder about the legalities of that outside of school hours too. I don't need to know what her blood sugar is on a weekend after having birthday cake at a friend's house, ya know?
My adult son has a cgm, and it was very useful when he was in ED with fractured ribs. Because, you know, you only get treated for the one problem you came in with. He was heading down sharply after he got propafol and ketamine for a chest tube insertion. I am sure no one would have realized he was low if his meter hadn't alerted us.
It has really helped with tight glucose control and to get his A1C below 7.
If you can get the school to supply an iPod or an iPad and the parent gives you access, you can monitor interstitial glucose in real time. Very helpful when you have unstable and/or multiple kids.
Maybe ask for a donation from parents? Tax deductible and no budget concerns. Just need one taker. I received a used one to take on field trips with contact info so I don't have to take a bulky binder.
We are looking into using the Follow App on a tablet in the health room at school. That way it is not on a personal device and can be used by a health room sub as needed. It is hard to find any documentation of its use by a school nurse. Trying to make sure we have everything covered on our end. Parents are really pushing for its use. On a similar note, Has anyone used a texting app for easier communication with parents that require frequent notification of treatment? Hate to use my personal phone but also hate to make a phone call just to give them an FYI.
Hate to use my personal phone but also hate to make a phone call just to give them an FYI.
Can you email an FYI? At the beginning of the year, I ask parents if they'd like to be called or emailed when their student runs low on medication. I just document how they want to be contacted and request a reply email to they acknowledge it.
What kind of doctor's orders does the student have regarding the Dexcom? I do think it is a fantastic tool, but I have a student (middle school age) who uses one and the mother calls constantly because she is seeing the readings on her phone. She also texts and calls her child if she doesn't see the number going up/down, or just to see if he treated. I can not run down to the student each time the mother sees a reading she doesn't like, and I have made this clear. I have also declined to put this on my personal phone. I can get email notifications, but I do not check my email frequently through the day because I am too busy! The student can check his sugar in class and has snacks in each class if he is low. Unless there is a problem after that intervention, I do not intervene. This is a capable child who is very used to mom doing everything for him. I am not being insensitive, as I do understand the severity of T1D and the rise and fall of blood sugar. I want this student to learn to listen to his alerts and react to them himself instead of relying on mom to text (during class) and say "You are 75, you need to eat four peanut butter crackers." And if he doesn't respond to the text, then mom repeatedly starts calling his phone (in class) and then calling the office to get me to go check on him.
The doctor's orders state that he should check before lunch, before and after gym, before getting on the bus, or anytime he is feeling symptomatic. These are the times that I assess the student, unless there is a problem.
So, I guess my point is, has anyone else had issues with parents seeing the numbers all day long? What kind of boundaries did you set? (My administration is scared to put restrictions on the diabetic students.)
The mom of my little guy has only called me 3 times since they got the app. Each time the kid was already in my office to check his BG and get a snack!
Just like with any good technology, there are those who will abuse it…..
nursej22, MSN, RN
4,859 Posts
My adult son has a cgm, and it was very useful when he was in ED with fractured ribs. Because, you know, you only get treated for the one problem you came in with. He was heading down sharply after he got propafol and ketamine for a chest tube insertion. I am sure no one would have realized he was low if his meter hadn't alerted us.
It has really helped with tight glucose control and to get his A1C below 7.