Type 1 4-year-old low!

ruby_jane, BSN, RN · Oct 9, 2017

How low? Refused to open mouth for icing sugar or a sugar packet? Refused some grape glucose tabs? Do you have glucagon?

On the one hand, we know that lows can cause kids to be oppositional. On the other hand....I never want to be That Nurse, the one who force-feeds juice. I try to have enough modalities of quick carbs to get those in a kid.

I suppose if nothing worked I'd be calling parent and having that glucagon on stand-by.

chasinRT · Oct 9, 2017

He was 48; refused to open mouth, refused everything we offered. Refused to talk on phone to mom. I did have Glucagon with me and thankfully it didn't come to that. Got enough sugar in to the buccal mucosa for him to start coming up and be rational. It was not fun.

OldDude · Oct 9, 2017

Another kid snatched from the jaws of death!! You did well and praise be to GOD you were present.

aprilmoss · Oct 10, 2017

Maple syrup. Been there with my own son. You usually can smear enough of it on his lips even when he was being difficult to start his sugar up.

Amethya · Oct 10, 2017

Not even candy?

OldDude · Oct 10, 2017

Maple syrup. Been there with my own son. You usually can smear enough of it on his lips even when he was being difficult to start his sugar up.

Syrup - don't leave home without it!!

We were camping one time and my dog started staggering around, falling down, in some kind of stupor. I slathered his mouth full of syrup and in a few minutes he was back in action!

ruby_jane, BSN, RN · Oct 10, 2017

I just realized the tip of the tube of icing sugar I have (which was one third of the price of the glucose rescue in the medical catalog) would fit neatly into a compressed mouth. Of course, then I'd have to explain why the kid has blue lips....

aprilmoss · Oct 10, 2017

We used to do the CakeMate thing but that isn't as easy as syrup.

SharePRN · Oct 14, 2017

I had the same thing but with my 75 yo father...in the middle of a restaurant....while he is pounding his fists on the table and yelling about how he is NOT having a good time. Tried to get a straw into his mouth for some coke and he clenched his teeth shut. I was running up to waiters asking is they had syrup, no...but we have honey. I kept clanging that spoon against his teeth until he opened up and then he bit down on the spoon. I thought he was going to break his teeth. I eventually got him back to normal but it was traumatic for all my family, especially all the grandkids. Came with a new admiration for Auntie Nurse!

Right now I'm caring for a diabetic 2nd grader with a tendency to elope and run out onto the back field. We've been told not to chase. So far that has happened to me but I feel for you. He doesn't like juice boxes either. :|

The good thing about the cakemate is that you can squirt it into the cheek whereas the syrup needs some delivery vessel like syringe or straw.

gracie65 · Oct 17, 2017

As a "former" child diabetic (Type I, diagnosed at age 4) and now an RN, I really feel your pain on this one. Syrup or cake frosting were good choices as they can be placed in the cheeks or under the tongue, especially if he wouldn't eat anything. It could have been worse....up until I was 12 or 13 I had violent seizres with low blood glucose during the night. Scared my Mother to death. And when they happened, sometimes she couldn't get any juice/pop down me either. Thank God for Glucagon! I try and emphasize to my co-workers that when a diabetic's blood glucose is THAT low where they are becoming almost nonresponsive and really out of it, that anything liquid or semi-soft (like syrup or frosting) are the best way to go. If they're conscious, I say go with pop or OJ with some sugar stirred in. I STILL hear the adage "give them candy" or like Glutose is in our protocol but totally ineffective (I've tested it myself....4 times. Didn't push my bloos sugar from 48 to above 75 in 15 minutes). We need a revision of how we treat diabetics with severe lows in health care. I'm pretty sure the protocols used in most hospitals today were written over 20 years ago before the onset of rapid-acting insulins AND were not written by anyone who's ever HAD a low blood sugar. Making someone take only 15 carbs, wait another 15 minutes and then hope again it's "normal" is just cruel, especially when sweating, startving and losing your mind. Would we make a pt. with an MI wait an additional 15 minutes for Nitro? Or an aspirin? Sorry, kind of got off track on my soapbox, but yes, you did the right thing, and I'm sure it was VERY scary. Can you imagine trying to jab Glucagon or get IV access for Dextrose in a squirmy toddler? Glad you were able to get enough sugar in to make a difference. Another note: candy bars, anything you have to chew is fine if a low is coming on, but you have to chew the food, swallow it and wait for your body to release the glucose for it to be effective, and when someone is in a blood sugar crisis, time is EVERYTHING and you need something to act quick; either through buccal absorption, or liquid or worse yet, D5 injection or glucagon. And say a prayer for that child's mother, because raising a diabetic child is one of the most difficult things you can do. My Mom went above and beyond to take care of me, make sure I was healthy, worried incessantly about me, and risked her own health in order to do so. My Mom had Type I diabetes for 48 years until a stroke claimed her life last year......

WineRN · Oct 17, 2017

He was 48; refused to open mouth, refused everything we offered. Refused to talk on phone to mom. I did have Glucagon with me and thankfully it didn't come to that. Got enough sugar in to the buccal mucosa for him to start coming up and be rational. It was not fun.

You are a rock star for handling that so well. :)