CALEB Type 1 Diabetic Peanut Allergy

Signs of Hypoglycemia for Caleb can be: Doesn't feel well, complains of wobby legs or dizzy, stumbling, slurring. Lethargy. OFTEN CALEB HAS NO SYMPTOMS.
If Caleb is conscious but nonresponsive or unable to chew a tablet, glucose gel should be squirted between his cheek and lower jaw and rubbed gently.

Mother: Lorraine Cell: Home:

VOMITING IS A DIRE EMERGENCY CALL PARENT

SEVERE HYPOGLYCEMIA (LOW BLOOD GLUCOSE)

If Caleb is unconscious with a severe low, a glucagon injection should be administered and 911 called - refer to 504 plan for dosing.

Blood Sugar

Before lunch *

9:30AM & Other Times (Consider Active Insulin)*

Dismissal on Bus (Consider Active Insulin)

If blood sugar is under 70, increase below suggested carb intake by 10-15 FAST ACTING carbs and call parent. Consider 4-8 carbs AND reduce meal bolus by 5 carbs Consider 10-20 carbs ** Consider 15 carbs 70-90 Reduce meal bolus by 4-8 Consider 4-12 carbs ** carbs Consider 4-12 carbs 90-120

120-150 150-200 OVER 200

Normal meal bolus Administer correction and proceed with normal meal

No action ** Administer correction

Consider 0-8 carbs Consider correction if >175, Otherwise, no

CHECK INFUSION SITE and CALL PARENT

* PUMP THERAPY USES FAST ACTING INSULIN - IT BEGINS TO WORK 20-30 MINUTES AFTER A BOLUS IS ADMINISTERED AND CONTINUES TO WORK FOR AT LEAST 2 HOURS. ALL ACTIONS SHOULD BE ADAPTED IF WITHIN 2 HOURS OF LAST BOLUS. ** CONSIDER TREATING WITH MORE CARBS BASED UPON RECENT TRENDS
107066077.xls.ms_office 8/22/2012 4:52 PM

CALEB Type 1 Diabetic Peanut Allergy

Mother: Lorraine Cell: Home:
Signs of Hypoglycemia include: - Doesn't feel well - Lethargy - Paleness - Slurred speech - Stumbling - Not making sense

(1) If Caleb is suspected of having a "Low", he must check his blood sugar where he is and, if confirmed low, eat fast carbs IMMEDIATELY (2) If a low blood sugar is not treated immediately, seizure, passing out and/or the need for emergency medical treatment are at risk (3) Caleb's pump pack should be maintained in the same room (or playground) as him at all times including during drills or evacuation (4) Caleb should not be left alone or sent anywhere alone if a low is suspected

VOMITING IS A DIRE EMERGENCY

OFTEN CALEB HAS NO SYMPTOMS

SEVERE HYPOGLYCEMIA (LOW BLOOD SUGAR)

If Caleb is conscious but nonresponsive or unable to chew a tablet, glucose gel should be squirted between his cheek and lower jaw and rubbed gently. If Caleb is unconscious with a severe low a glucagon injection should be administered and 911 called.

107066077.xls.ms_office

8/22/2012 4:52 PM