I am a new public school nurse and have never worked with type 1 diabetics before. I will need to do glucagon training soon and the question has come up as to whether to test or not before giving the glucagon.
Our lead nurse has said no, we don't test first. But my husband who is a physician says that teenagers are more likely to be in DKA than hypoglycemic.
Thoughts on how you would train teaching staff, and what you would do yourself?
I will be working with a fourth grader in one school and with high school students as well.
One of the issues my husband has brought up is that there are so many different glucometers that it would be hard to know how to quickly use them all--especially if it's not something you are routinely doing. Because that could slow down the administration of the glucagon & because my supervisor said don't test, I am going to train them to just give it if the student is symptomatic and unable to swallow something. I hope that when our lead nurse returns from maternity leave I could ask her to write a policy on it. I have 2 different glucagon information sheets that I got off of our shared drives that each say something different. One says test if possible; the other has it underlined "do not test."
I think asking for a policy on it would help me feel more comfortable one way or another. My husband says it is quite possible to have different doctors who would feel differently on the subject. Maybe I am worrying too much or splitting hairs, but I'd like to see a policy on it. Thanks for all the comments friends!!
So I finally found on one of our glucagon information sheets that for mild symptoms of hypoglycemia that we check first, but for moderate symptoms we treat without checking. For severe symptoms just give the glucagon. So now I have it in black and white from our district's nursing documents. Maybe that will change in the future....
Thanks for all the help friends. I don't know of any specific plan that the doctors give regarding glucagon. In fact, the endo that is most frequently used apparently doesn't like to sign orders and so the parents are supposed to fill out the correction formulas/carb ratios and then we send to the DNE who will sign them. On our DMMP's there is just a spot to note whether they have glucagon and whether it is .5 or 1mg.
On a different note....I had a meeting with one of my diabetic students and her mom this afternoon. The mom walked into the room in pretty severe chest pain. The only other symptom was nausea, (some heavy breathing from the pain). She kept heaving but never vomited. No other symptoms--good color, warm, dry skin etc--but had a history of arrythmia and blood clots in her legs. So I had to call the ambulance.
Sorry your endos are like that. We get a 4-5 page individualized medical management plan for each student from our pediatric endos. Any time there is a change in anything they fax a new one to us. It's all computer generated, so not really any extra work on their part, just print off from their last visit, sign and fax.
J-lynn
44 Posts
One of the issues my husband has brought up is that there are so many different glucometers that it would be hard to know how to quickly use them all--especially if it's not something you are routinely doing. Because that could slow down the administration of the glucagon & because my supervisor said don't test, I am going to train them to just give it if the student is symptomatic and unable to swallow something. I hope that when our lead nurse returns from maternity leave I could ask her to write a policy on it. I have 2 different glucagon information sheets that I got off of our shared drives that each say something different. One says test if possible; the other has it underlined "do not test."
I think asking for a policy on it would help me feel more comfortable one way or another. My husband says it is quite possible to have different doctors who would feel differently on the subject. Maybe I am worrying too much or splitting hairs, but I'd like to see a policy on it. Thanks for all the comments friends!!