Chapter Eight: When Do I Take My Child to the Emergency Room?

The answer to this question is whenever you are faced with a situation that you do not feel prepared to handle. Or when you don't think you should wait for the doctor to call you back. If you think it's an emergency, it's an emergency. Don't be shy. This is your baby.

We've had one instance. Kari went real low again. She had similar symptoms to the first time. It was the last day of school this past year. She woke up and couldn't come up with the word "toothbrush" or the word "part" for her hair. She couldn't check her own blood. She was fairly lucid other than some slight confusion. Although when I checked her blood she tested low normal, around 70, I couldn't get rid of the symptoms. I sent her younger sister Kristin (you'll meet her later) off to school and Kari and I headed to the emergency room. They couldn't give me a definitive answer as to why but after a couple of hours on an IV drip she didn't look like Uncle Fester anymore and was up and being her old self again. She made it back to school for the last half- hour and was able to say goodbye to all of her friends for the summer. Remember that an emergency is whatever you think it is.

Another thing along these lines you should plan for is when your child gets sick. If your child is in school it's almost guaranteed they will bring home some sort of bug. Be prepared before it happens. Your doctor or diabetes educator has probably already warned you about this. Follow their instructions. The following information is from the American Diabetes Association. Check with your doctor first! Check with your doctor first! Check with your doctor first!

To take care of your child's diabetes along with her current illness, follow these general principles:

Continue Insulin Treatment

Your intuition might tell you to reduce or stop your child's insulin, especially if she is not eating very much. Younger or newly diagnosed children could need reduced insulin depending on their blood glucose level, but other children need just the opposite-extra insulin. Ask your doctor for guidelines for insulin treatment on sick days and call the doctor anytime you're not sure how much insulin to give.

Stay Close to the Meal Plan

You may want to substitute soup and other comfort foods for the usual fare. Be sure to maintain about the same meal times and number of carbohydrates at each meal and snack as you would on a normal day. If your child has an upset stomach and can't eat, give her clear liquids that contain carbohydrates (sports drinks, juices, gelatin, broth, frozen fruit bars).

Give Plenty of Liquids

Encourage your child to drink as much water and other non-caffeinated beverages as she can.

Choose Medications Wisely

Many over-the-counter medications contain sugar and/or alcohol. Although there might not be too much glucose in one dose of cough syrup, it can add up if your child takes it every four hours. If you can't find a glucose-free version or if it's more expensive, just account for the medicine's carbohydrates in the meal plan. Medicines that contain alcohol can lower blood glucose levels. If you choose a medicine that contains alcohol, have your child eat something when she takes it in order to prevent hypoglycemia. You may wish to choose alcohol-free medicines.

In addition, certain medications can affect your child's diabetes. Many decongestants can raise blood glucose levels. And ibuprofen is not safe for anyone with kidney problems. Ask the doctor what over-the-counter medications he or she recommends for your child.

Check Blood Glucose and Ketone Levels Frequently

Diabetic ketoacidosis (DKA) is a danger whenever your child is sick. DKA occurs when a person with diabetes has too little insulin in their system. If left untreated, DKA can lead to coma. To prevent DKA or catch it early, check your child's blood glucose levels often (every few hours) while she's sick. Also, check her urine for ketones several times a day. If she is vomiting or has diarrhea, check ketones even more frequently (maybe even every time she urinates, depending on the severity of the illness).

Foods for Sick Days

When your child is not feeling too well, she may not feel like eating a lot of the foods she normally loves. For example, if her belly is doing somersaults, she's probably not craving a big, spicy plate of nachos. But it's important for her to eat in order to keep her body from burning fats for fuel (and making ketones) and to keep her body energized so it can get better fast. Here are a few flu-friendly food ideas for when a bug has your child down.

  • Liquids
  • Fruit Juice
  • Jell-O
  • Milkshakes
  • Popsicles
  • Soups & Broths (try bouillon, chicken noodle soup, or plain hot broth)
  • Solids
  • Fruit
  • Ice Cream or Sherbet
  • Hot Cereal
  • Toast
  • Crackers

SOURCE: American Diabetes Association
http://www.diabetes.org/for-parents-and-kids/diabetes-care/surviving.jsp


Next

Chapter Nine: "I Feel Different from Everyone Else"


 

Legal Statement

The Book "So Your Child Has Diabetes" A Step by Step Plan for You and Your Child , is Copyright © 2004 by Russell A. Turner.

No part of this book may be reproduced, stored in a retrieval system, or transmitted by any other means: electronic, mechanical, photocopying, recording, or otherwise, without prior written permission of the copyright holders. This book is supplied for information purposes only and, as experienced in this subject matter as the contributors are, the material herein does not constitute professional medical advice. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered. It is sold with the understanding that the publisher and contributors are not engaged in rendering medical, psychological, or other professional advice. If medical or other professional assistance is required, the services of a competent professional should be sought. The reader is advised to consult with an appropriately qualified medical professional before making any medical decision. The publisher and contributors do not accept any responsibility for any liabilities resulting from decisions made by the purchasers of this book.

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