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[IP] ER-Camp letter
Dear Pumpers and Friends,
As I was reading some mail, I remember a letter I had my doctor write
for me many years ago after I read about it in ADA Diabetes Forecast. It
is a letter for ER personnel but I think it will work for camp personnel
To:Emergency Care Personnel,
Rodney F. Mead, Jr. uses an insulin pump to meet his needs for
insulin because of Type 1 Diabetes Mellitus. The insulin pump delivers
insulin in a way that more closely mimics insulin release by the normally
functioning pancreas than does one or two injections a day. Rodney pump
matches his insulin needs as determined by history, blood glucose levels,
food to be eaten, and expected exercise. Normally, Rodney checks his blood
glucose levels with a home glucose meter and adjusts insulin deliver to
maintain as near normal blood glucose levels as possible.
Insulin is given two ways via the insulin pump:
*Basal rate: a continuous insulin infusion, the amount of insulin
patient requires to maintain a normal metabolis state when not eating.
*Bolus: the insulin infused with food intake. The patient is taught
to adjust this depending on blood glucose levels, food to be eaten , and
1) Leave pump in place. Continue basal rate, even if Rodney is
unable to eat. His set basal rates are as follows:
12am thru 4am 0.6units per hour
4am thru 7am 2.5units per hour
7am thru 8pm 1.2units per hour
8pm thru 10pm 0.8units per hour
10pm thru 12am 0.6units per hour
Infusing Human Velosulin U-100
2) Allow Rodney to test his own blood glucose levels with a glucose
meter and adjust bolus as he has been taught. Bolus will be adjusted as
1unit insulin to 9CHO
<70 subtract 1unit from boluse
140-200 add 1.0 unit
200-250 add 2.0 units
250-300 add 3.0 units
300+ add 4.0 then check blood glucose every 2 hours
3)If Rodney is ketotic, it probably means that the pump is not
functioning properly or is blocked or been removed. Have Rodney change the
tubing and needle and reinsert. Have Rodney check his blood glucose levels
every 2 hours and bolus doses as above.
4) As noted previously, continue the basal rates if Rodney is unable
to eat. Blood glucose levels should be checked, by Rodney if possible, every
4 hours, and boluses adjusted as above.
*DO NOT DISCONTINUE PUMP without giving insulin by another means.
Otherwise, Rodney will have no insulin and will develop ketoacidosis. If the
pump is discontinued, Rodney will immediately need Regular insulin.
*Blood glucose measurements used to determine bolus adjustments must be
current. It's much safer to make adjustments from Rodney's readings than to
wait for blood glucose results from the lab. Rodney has been trained to do
this, and routinely does it eight times a day, so it is second nature.
The exceptions to this rule are: if there is doubt about the
patient's ability to perform intelligently or if there is concern about the
accuracy of the glucose meter.
*If Rodney has an infection or is under stress, blood glucose levels
may go up. Continuing the basal dose and covering high blood glucose levels
with boluses is a reasonably safe way of doing things.
Rodney's other medical problems :
1.Type 1 Diabetes Mellitus, treated by external pump delivering
continuous subcutaneous insulin infusion.
2. Gastrointestinal autonomic neuropthy, with Severe gastroparesis
and bowel dysmotility.
3. Diabetic Peripheral Neuropathy
4. Diabetic Retinopathy
5. Diabetic Nephropathy
6. Frequent and severe hypoglycemia and the inductio of seizure
activity, this being precipitated in large part by the erratic and
unpredictable absorption of foodstuffs induced by the gastrointestinal
Patient's Name:Rodney F. Mead, Jr.
Doctor's Name: T. Gallager
Doctor"s Address: Earth
Doctor's Phone #1313
This insulin pump is manufactured by: Pumps-r-u
Customer service phone number is: 1-800-PUMPSRU
It did read : the patient = Rodney
I also had listed allergic and other things at the end of letter
I hope this will be of help to everyone, I know it has helped me at times in
the ER. Most of the time they want to remove my pump. Only from my cold dead
hands will they remove my pump or until they cure DM. So remember
SMILE AND BE HAPPY
Insulin Pumpers website http://www.insulin-pumpers.org/
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