Emergency Room Visits for Kids with Diabetes
Laura Plunkett., BA Psychology

As the parents of a very active but accident-prone 13-year-old, my husband and I have had our share of emergency room visits. We have rushed Danny to the hospital for a stomach flu with ketones, a lacerated cornea, a deeply-cut foot, acute stomach pain, and a severe bout of croup. With blood sugar control added to our list of concerns, emergencies become very complicated. Over time, we have learned that preparation can make the experience safer. In addition, when parents are prepared and calm, the medical team will be more cooperative in dealing with a child’s diabetes care.

These are our best recommendations:

1. Call ahead to alert the emergency room to your arrival and ask to register by phone. In our case, we have two hospitals within reach. One will tell you how long the wait is, pre-register your child by phone, and start a triage assessment while you are on the way. The other hospital will not. Mention that your child has diabetes. On one occasion, our hospital had reached our endocrinologist before we arrived.

2. Bring all your diabetes supplies and snacks and water to cover the possibility that you may be admitted. You will want high and low carbohydrate choices, depending upon your child’s blood sugar levels, as well as glucose tabs.

3. Know your child’s allergies to food and medication and make sure to list them when you arrive.

4. If possible, check ketones and do a blood sugar check before you arrive or while you are waiting. We have found that if you know your child’s number and ketone level, you immediately get a better response from your assigned nurse and doctor. In addition, the hospital process for both of these tests takes longer than if you do it yourself.

5. Similarly, closely monitor blood sugar levels throughout the experience. Even if your visit to the hospital is unrelated to the diabetes, a variety of factors including stress, illness, and adrenaline can make blood sugars change quickly. If you decide to treat a low or give extra insulin to counteract high blood sugars, be sure to communicate this to your nurse or doctor.

6. Encourage your emergency room doctor to consult with your endocrinologist. On one occasion, when our son had croup, our emergency room doctor chose a steroid and our endocrinologist chose the insulin dose, adjusting for the steroid.

7. Before your child receives any medications, be sure to ask whether they affect blood sugars.

8. Wash everyone’s hands as often as possible. You and your child are being exposed to a multitude of germs on door handles, light switches, toys, magazines, bathroom fixtures
and bed rails. You don’t want to have to return because you caught someone else’s flu!

Emergency room visits are never pleasant, but playing a pro-active role in your child’s treatment can help you all have a more successful experience.

Laura Plunkett is a columnist for Diabetesincontrol.com and Diabetes Health magazine and author of the book, "The Challenge of Childhood Diabetes: Family Strategies for Raising a Healthy Child." She recently spoke at the Juvenile Diabetes Symposium at the University of California, San Francisco. The Plunkett family has been featured in the Boston area on television, radio, and many local and national parenting magazines and newspapers. Laura currently speaks on the topic of "Raising Wholesome Children in a Fast-Food World: A Framework for Family Health" with her mother, Linda Weltner, and her daughter, Jessica. She had a thriving therapeutic private practice for 14 years with families, individuals and couples. Laura can be reached at lauramplunkett@challengeofdiabetes.com