Receiving a diabetic patient (insulin dependent) from ER, serum glucose was approx 220 five hours earlier, pt has been NPO for at least same 5 hours. No capillary glucose check done at any time since arrival. No insulin or hypoglycemia management orders entered.
Request ER nurse to check capillary glucose before sending patient up. Was told that was a ridiculous request since there was "nothing I can do about it anyway" since no orders. I said I was only concerned about a possible low, that I would deal with getting insulin orders on the floor if it was high. Got more resistance and a "whatever, fine" and basically got hung up on.
I don't get the resistance to checking it before transport...insight anyone?
Specializes in orthopedic/trauma, Informatics, diabetes.
Our ED is very bad about checking BG and we have had some dangerous lows. I would not have been worried about a 220, in fact it would be somewhat reassuring knowing that probably weren't going to crash. I probably would have waited until they got to me unless is was going to be an unreasonable amount of time. .
I would do that myself as part of the initial assessment. If the ED nurse takes the glucose and it is low, then THEY would have to follow through with that.
If your concern was a low BS, then when taking it yourself, you could deal yourself at that time. (a snack, for instance)
If there's an infectious process going on (hence IV antibiotics) then the BS can be higher than the patient's normal. So I do get your thought process. However, since the patient was reported off to you, I would take it from there. I would ask the hospitalist writing the admission orders to include a sliding scale perhaps.
mmc51264, BSN, MSN, RN
3,319 Posts
Our ED is very bad about checking BG and we have had some dangerous lows. I would not have been worried about a 220, in fact it would be somewhat reassuring knowing that probably weren't going to crash. I probably would have waited until they got to me unless is was going to be an unreasonable amount of time. .