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Diabetes: Emergency Treatment
Health Issue Category
Diabetes
Date of Issue
Revision Date
February, 2006
Related Policies, Administrative Procedures and Forms:
 

Hypoglycemia (Low Blood Glucose) - An Emergency!



Hypoglycemia is an emergency situation caused by low blood glucose. This situation can develop within minutes of the child appearing healthy and normal.

Causes

  • Low blood glucose usually develops as a result of one or more of the following:
  • Insufficient food due to a delayed or missed meal;
  • More exercise or activity than usual without a corresponding increase in food;
  • and/or too much insulin.
Symptoms

A person who is experiencing hypoglycemia will exhibit some of the following signs:

  • Cold, clammy or sweaty skin;
  • Pallor;
  • Shakiness, lack of coordination (e.g. deterioration in writing or printing skills);
  • Irritability, hostility, and poor behaviour;
  • A staggering gait;
  • Fatigue; and/or
  • Eventually fainting and unconsciousness.
In addition the child may complain of:

  • Nervousness
  • Excessive hunger
  • Blurred vision and dizziness
  • Headache
  • Abdominal pain or nausea
Treatment

It is imperative at the first sign of hypoglycemia to give sugar immediately. If the parents have not provided you with more specific instructions which can be readily complied with, give: 4 oz./125 ml of regular pop (not diet pop); or 4 oz. /125 ml of fruit juice; or 2 teaspoons/10 ml or 2 packages of sugar; or 2 glucose tabs; or 2 teaspoons/10 ml honey. It may take some coaxing to get the child to eat or drink but you must insist.

If there is no noticeable improvement in about 10 to 15 minutes repeat the treatment. When the child’s condition improves he or she should be given solid food. This will usually be in the form of the child’s next regular meal or snack.

Until the child is fully recovered, he or she should not be left unsupervised. Once the recovery is complete, the child can resume regular classwork. If, however, it is decided that the child should be sent home, it is imperative that he or she be accompanied by a responsible person.

Parents should be notified of all incidents of hypoglycemia. Repeated low blood glucose levels are undesirable and unnecessary and should be drawn to the parent’s attention so that they can discuss the problem with their doctor.

If unsure whether the child is hypoglycemic, always give sugar! A temporary excess of sugar will not harm the child but hypoglycemia is potentially serious.

NOTE: Do not give food or drink if the child is unconscious. Roll the child on his/her side and seek medical assistance immediately, call 911.

High Blood Glucose



Children with diabetes sometimes experience high blood glucose. The earliest and most obvious symptoms of high blood glucose are increased thirst and urination. If noticed, these should be communicated to the parents to assist them in the long-term treatment. They are not emergencies that require immediate treatment.

Causes

High blood glucose often develop as a result of one or more of the following:

  • too much food;
  • less than the usual amount of activity;
  • not enough insulin; and/or
  • llness.
Many times, however, there does not seem to be an obvious explanation.

The Sick Child

Kids with diabetes are no more susceptible to infection or to illness than their classmates. They do not need to be in a special “health class” at school. Their attendance record should be normal.

When kids with diabetes become ill with the usual fevers and other childhood sicknesses, the blood glucose balance is likely to be upset. Careful monitoring with the blood glucose and urine testing, a fluid diet and extra insulin may be required. Such illness management is the responsibility of the parents, not you.

When kids with diabetes become ill at school, the parents should be notified immediately so that they can take appropriate action.

Vomiting and inability to retain food and fluids are serious situations since food is required to balance the insulin.

If the child vomits, contact the parents immediately. If unable to reach the parents, take the child directly to the nearest hospital.


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