I work for a public junior high school and act as substitute health clerk. We have a 12 year old boy whose glucose ranges from 80-600 mg/dl [4.4-33.3 mmol/L] on any given day. I have called 911 for assistance when he became delusional with a very high reading, and they took him to the E.R. I have been told I over-reacted, but I don’t agree.

From what I have read from your web site, a blood sugar over 500 mg/dl [27.8 mmol/L] indicates a dangerous zone. I have been told by the school nurse to just give him water and walk him around campus, which has always proved to raise his numbers.

Am I over-reacting, panicking, and fearing the possibilities of seizures? I am ready to file with social services. I feel there is negligence in his care. Please, any suggestions or information would be greatly appreciated.

I appreciate that you are concerned and want to help, but it sounds as though some education is needed for the staff. Due to liability purposes, I think you need to proceed with caution. Is there a healthcare plan in place for this child? If not, you need to insist on that.

LSF
Additional comments from Stephanie Schwartz, diabetes nurse specialist:

I agree with Lois in that this young man needs to have a care plan signed by his physician. Blood sugar swings like this are not uncommon in a child this age and usually do not reflect impending danger unless there are moderate to large ketones in the urine as well. Please review our school manual. PEDS (Pediatric Education for Diabetes in the Schools) is a project in Orange County, California funded by the PADRE Foundation and the Health Funders Partnership of Orange County to educate all school nurses in the state of California about diabetes care. They are experts in 504 and other school issues and have excellent materials based on California law. Also see The Law, Schools, and Your Child with Diabetes.

Before doing anything, you need to express your concerns to this young man’s parents in writing, and set up a face to face meeting to address and develop a healthcare plan so that everyone’s responsibilities are clearly understood and documented. A school administrator, the school nurse, the young man in question, his parents, and, if possible a member of the diabetes team should all participate in devising the plan.

While I too appreciate your concern, you are not a licensed professional and need to be careful not to overstep your bounds.

SS