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[IPp] School Orders

Ok, everyone.  I, too, would appreciate some input and advice from those who
have kids in middle school.  Devin (14) will be starting off this year with
his pump, yeh!!  Last year he spent way too much time in the nurses office
because he didn't feel well. His BG's were up and down and mostly way too
high.  This year, thanks to the pump and his palm pilot's EZ manager, I want
Devin to stay OUT OF THE NURSE'S OFFICE.  The following is a work in progress.
Any advice or suggestions would be appreciated!

 School Orders for Devin Mulligan
 Blood Glucose Testing:

 Devin will test his Blood Glucose (in the classroom) at the following times
(indicated when his watch alarms):  mid-morning, before lunch, mid-afternoon,
before and after PE, before he walks home from school, and whenever he feels
low or high.

 Ketone testing:

 Devin will test his ketones if Blood Glucose is over 250 (he will keep the
test strips in backpack) If ketones are negative or small, Devin will give a
normal bolus.  If ketones are high, Devin will go to the nurse's office.  The
nurse will help Devin calculate a bolus of a 50% increase.

 Pump Management:

  Set Changes:  Devin will change his site as indicated ( set comes out, or
problem with site, such as,  occlusion)  Devin will use nurse's office to
change or insert new pump site.

 Pump malfunction:  In the event the pump malfunctions, school personnel will
contact his mother.  If mother is unavailable, Animas will be called at
1-877-937-7867 for tech support.

 Diabetic Supplies:  Back-up and emergency supplies will be kept in nurse's
office where Devin will have access to them when needed.  Nurse will notify
parents if supplies are
getting low or have expired.

 High Blood Sugar Bolus:  Devin will bolus for high blood sugar the amount
calculated on his palm pilot. Do not restrict bathroom breaks.  Provide water
for Devin, if thirsty.

 Low Blood Sugar:   Devin will eat part or all of a fruit snack/juice box as
indicated by a low blood sugar.  Then, Devin will retest his Blood Glucose
15-20 later.  Retreat, if necessary.  DEVIN WILL NOT LEAVE THE CLASSROOM UNTIL

 Treatment of seizure/unconsciousness:  Glucagon injections will be given per
instructions.  911 and parents are to be called immediately, in that order.
Glucagon kit and instructions for use will be kept in nurse's office and in PE

 PE Class:

Devin will test his Blood Glucose before and after PE class.  If activity is
particularly strenuous or long, Devin will test his Blood Sugar half way
through PE.  If Devin "feels" low, he will test.

If Blood Glucose is under 100, Devin will drink 1 juice box or eat 1 fruit

If Blood Glucose is over 250 and ketones are present, Devin will not exercise.
Non-participation due to this reason will not affect his average.

PE Teacher will be instructed on signs and treatment of Hypoglycemia including
Glucagon Injections.

Devin will decide whether he wishes to disconnect his pump during PE.  If he
disconnects, pump MUST be put somewhere safe from theft or tampering.


mom to Devin (14) dx 4/01, pumping since 5/02
email @ redacted
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