Re: [IP] Give Them a Writen List of Your Medicines ER LETTER
You've added some very good suggestions of more information we should carry
on our person in case of medical need. It's certainly best to be over
cautious where our health condition and needs are concerned. A doctors
signature is a real plus in relation to our pumps until he/she can be
reached in the case of an emergency.
Anyone have other ideas or important additions to add to Rodney's letter?
email @ redacted
Subject: [IP] Give Them a Writen List of Your Medicines ER LETTER
> TO: EMERGENCY CARE PERSONNEL
> NAME uses and insulin pump to meet his needs for
> because of Type 1 Diabetes Mellitus. The insulin pump delivers insulin in
> way that more closely mimics release by the normally functioning pancreas
> than does one or two injections a day. NAME 's pump matches his
> insulin needs as determined by history, blood glucose levels, food to be
> eaten, and expected exercise. Normally, NAME 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 the
> requires to maintain a normal metabolic state when not eating.
> Bolus: the insulin infused with food intake. NAME has been taught to
> adjust this depending on blood glucose levels, food to be eaten, and
> expected exercise.
> Leave pump in place. Continue basal rate, even if NAME is unable
> eat. NAME is infusing NovoLog Human Insulin Analog U100.
> His set basal rates are as follows:
> 23:59 to 04:00 units per hour 12:00 to 13:00 units per hour
> 04:00 to 06:00 units per hour 13:00 to 18:00 units per hour
> 06:00 to 08:00 units per hour 18:00 to 19:00 units per hour
> DAILY USE
> 08:00 to 11:00 units per hour 19:00 to 20:00 units per hour
> units per month to fill tubing
> 11:00 to 12:00 units per hour 20:00 to 24:00 units per hour
> basal bolus =/-9% = Units
> Allow NAME to test his own blood glucose levels with a glucose
> meter and adjust bolus as he has been taught. Bolus will be adjusted as
> 1 unit insulin to grams of carbohydrate High blood sugar bolus 1 unit
> drops mg/dl
> BLOOD GLUCOSE ADJUSTMENT
> <70 mg/dl Subtract 1 unit from bolus
> 70 to 100 mg/dl No Adjustment
> Every mg/dl above mg/dl Add unit
> Every mg/dl above md/dl Add units
> If NAME need to bolus to counteract a high blood glucose
> NAME will check his blood glucose levels every two hours until it
> returns to normal plus 4 hours
> If NAME is ketotic, it probably means that his pump is not
> functioning properly or is blocked or been removed. Have NAME do a
> site and pump check, if problem is found he will do a change as he has
> taught. Have NAME check his blood glucose every 2 hours and bolus
> As noted previously, continue the basal rates if NAME is unable to
> eat. Blood glucose levels should be checked, by NAME if possible,
> every 3 hours, and boluses adjusted as above.
> *DO NOT DISCONTINUE PUMP without giving insulin by another means.
> NAME will have no insulin and will develop ketoacidosis. If pump is
> discontinued, NAME will immediately need Regular Insulin.
> *Blood glucose measurements used to determine bolus adjustments must be
> current. It's much safer to make adjustments from NAME's reading than
> wait for blood glucose results from the lab. NAME has been trained to
> this, and routinely does 15 times a day, so it is second nature to him.
> *The exceptions to this rule are if there is a doubt about NAME's
> ability to perform intelligently or if there is concern about the accuracy
> of the glucose meter.
> *If NAME has an infection or is under stress, blood glucose levels
> may go up. Continuing the basal dose and covering high blood glucose
> with boluses is a reasonably safe way of doing things.
> NAME's Medical Problems:
> Type 1 Diabetes Mellitus, treated by external pump delivering continuous
> subcutaneous insulin infusion.
> Gastrointestinal autonomic neuropathy, with severe Gastroparesis and bowel
> Diabetic Peripheral Neuropathy.
> Diabetic Retinopathy.
> Diabetic Nephropathy
> Frequent and severe hypoglycemia and the induction of seizure activity,
> being precipitated in large part by the erratic and unpredictable
> of foodstuffs induced by the gastrointestinal motility disorder.
> Loss of Left Eye.
> Name: ADDRESS
> PUMP:Minimed sn#
> Omaha, NE 68105-2315
> ER CONTACTS:
> Health Insurance Info:
> Birthday birth place mother name
> Endocrinologist: Clinic:###-###-####
> Endo:###-###-### Pager:###-###-##
> PCP: Clinic:
> Dermatology: Podiatry:
> TO HAVE OPERATOR TO PAGE DOCTOR
> MEDICAL HISTORY: (SAMPLE OF THINGS)
> Tonsils & Adenoids (1968)
> Nose DS at (1976)
> Diabetes Mellitus Type 1 (5-20-77)
> Severe Gastroparesis at (1980)
> Started on Insulin Pump 10-7-1980
> Hands: Carpal Tunnel in 1991 RIGHT - 1992 LEFT
> Trigger Fingers:
> Stopped working April 10, 1998 on Total Disability Social Security.
> Pick-lines since 1987 for Erythromycin IV on/off since.
> Port left side placed in 1998 for TPN
> Major infections 5 times in 1998
> J-tube placed 1998
> Drugs & Meds: (SAMPLE OF THINGS) Drug dose
> NovoLog Insulin
> Minimed 508 insulin pump S
> Infusion Set (Silhouette or Quickset) 1 every 3 days SHIP
> Batteries as needed SHIP
> Cartridge 1 every 3 days SHIP
> Skin Preparation: SHIP
> Skin Prep as needed
> I.V. Prep as needed SHIPN
> Unsolve as needed SHIPN
> Hibiclens Soap as needed SHI
> Transparent Dressing as needed SHIN
> Glucometer Elite Meter & Strips 14 AVE daily SAN
> Glucagon ER Kit 1mg as needed SN
> Acetaminophen 500mg as needed HUS
> Enteric Coated Aspirin 325mg 1 daily HUS
> Vitamin C 500I.U. 1 - 3 x daily HUS
> Vitamin E 400I.U. 1 - 3 x daily HUS
> Centrum Vitamin 1 daily HUS
> Flonase 0.05% 1 - 2 x daily HUS
> Allegra 180mg 1 daily HS
> Pancrease Capsules as needed Ave 12 DISE
> Metronidazole 500mg 1 - 3 x daily DIE
> Doxycycline 100mg 1 - 2 x daily DIE
> Lac_Hydrin 12% lotion 400gm 1 daily PAAN
> Outgoing mail is certified Virus Free.
> Checked by AVG anti-virus system (http://www.grisoft.com).
> Version: 6.0.483 / Virus Database: 279 - Release Date: 5/19/2003
> for HELP or to subscribe/unsubscribe, contact:
for HELP or to subscribe/unsubscribe, contact: