Supplies she keeps in her classroom
Supplies she keeps in the Health Office
Kortnie Silverhorn
Type 1
Diabetic – Insulin Dependent – Uses an Insulin Pump
In
Emergency call 911
We prefer Summit
Healthcare in Show Low or
Cardon Children’s Medical
Center – Mesa, AZ
Blue Cross Blue Shield of
Arizona
Subscriber # XBP 850987661
(Brian Silverhorn)
Amanda Silverhorn (mom) – ###-###-####
Brian Silverhorn (dad) – ###-###-####
Brian Work – Show Low Motorsports – ###-###-####
Linda Prentice (Grandmother) – ###-###-####
Brandon Silverhorn (Uncle) – ###-###-####
Endocrinologist
– Dr. Joel Hahnke (Southwest Pediatric
Endocrinology)
###-###-####
fax
###-###-####
Diabetes
Educator – Jeanette Larsen (Show Low Hospital)
###-###-####
Kortnie Silverhorn has
Type 1 Diabetes
What is it? This
disease occurs when the body’s immune system attacks and destroys the insulin
producing beta cells located in the pancreas.
Insulin is a hormone that helps the body move glucose (sugar) contained
in food into cells throughout the body. The cells need glucose for energy. When the beta cells are destroyed, no insulin
can be produced and glucose stays in the blood instead. If glucose stays in the bloodstream, it can
cause serious damage to all the organ systems of the body.
What does it mean for
you? The important thing to remember is that Kortnie is a healthy,
happy, normal child. Caring for her requires a little extra
knowledge to get her through each day safely with good blood sugar control.
What is the
treatment? Kortnie receives Insulin via in Insulin
Pump 24 hours a day. (Every 3 minutes she receives a small amount of Insulin
automatically, and then when eating or experiencing a High Blood Sugar, she can
manually give herself a dose of insulin via the pump) This type of therapy requires frequent blood
sugar checks. I will check her first
thing in the morning and when she’s dropped off at school. You will need to send her to the Health
Office 5-10 minutes before lunch, she and Miss Sharon will check her blood
sugar and administer insulin via her pump for her lunch. Occasionally she will have to go back to the
Health Office for a check after lunch.
(Kortnie or Miss Sharon will let you know if this needs to happen) Also,
Kortnie will have her meter with her at all times in the classroom. She needs to be able to check her blood sugar
at any time she feels the need. Also, if
she is acting out of character or you are concerned you can have her
check. Her blood sugar goal range is 80-140,
but 80-175 is an acceptable range as well.
Special Classes or
Activities –
PE-
Physical Activity can make her blood sugar drop, she should bring her meter and
a source of sugar to PE class – glucose tabs or juice box
Fire Drill- She should bring her meter with her when
exiting the building for a fire drill, also the Teacher, Kortnie or another
Student should get into the habit of bringing her Classroom Emergency Kit as
well.
Lockdown- In the event of a Lockdown, please try to make sure that she
has her testing supplies as well as a source of sugar (juice box, glucose tabs,
Smarties, any kind of candy) available to her.
Field Trips, Track and Field Days, etc.- Please let mom know as far in advance as
possible for these types of days, mom or dad will make arrangements to
accompany Kortnie on field trips and or to be present at Track and Field days and
class parties where food is served.
Other Special Accommodations
Kortnie’s
insulin pump is connected by a tube that goes into her belly or arm, the actual
pump she wears either clipped to the waistband of her pants, in her pocket, or in a fanny pack around her
waist.
Please let all
Substitute Teachers know about Kortnie.
If possible let Kortnie know if you are going to have a scheduled
absence. In the case of a long term sub,
I’d love the opportunity to have a meeting with him/her.
Please let
special teachers and the other 3rd Grade teachers know about Kortnie’s
condition.
Kortnie needs
access to the restroom and nurse’s office at all times. (Exception of course
would be in a lock down situation)
She should always
be able to check her blood sugar when she feels the need.
We will provide
a kit in the classroom and nurse’s office with things she may need, sources of
sugar, extra test strips, extra batteries, emergency glucagon shot, alcohol
wipes, extra lancets, etc. If you are
running low on anything (usually sugar sources), please let me know. I’ll send in replacements with Kortnie on the
next school day.
If having a
class party, where food will be present, please let us know and we will make
arrangements for her to participate.
** She cannot have regular soda or juice (except in the case of a low
blood sugar), if having these items at a party, I can send in diet soda or
crystal light.
For Aims
testing we will need to make sure her blood sugar is within range before
starting the test, as Aims testing draws nearer we should plan a meeting to
discuss testing accommodations.
If Miss Sharon
is having a planned absence she will let us know, if she has a last minute
absence someone at the school should call mom and let us know.
Always feel
free to call mom or dad with any questions or concerns!
Emergency Situations- Everyone caring for Kortnie (including
special teachers and substitute teachers) must be aware of low and high blood
sugar signs and notify the school nurse or designated persons promptly, so that
Kortnie’s blood sugar number can be checked and then treated accordingly.
Low Blood Sugar- The only emergency that could come on
quickly is LOW BLOOD SUGAR. This can
occur if she gets more exercise than usual, does not eat her full meal, or receives
too much insulin, is ill, or is stressed.
The warning signs of low blood sugar vary, but include any of the following:
hunger, paleness, sweating, shaking,
eyes that appear glassy, dilated (big) pupils, personality changes such as
crying or stubbornness, headaches, inattentions, drowsiness, weakness, irritability,
confusion, speech and coordination changes.
IF NOT TREATED -> LOSS OF
CONSCIOUSNESS, SEIZURE, BRAIN DAMAGE, OR DEATH CAN OCCUR.
*WHEN KORTNIE IS LOW- She can look pale, have glassy eyes, her
hands may be shaky, and she may seem confused, irritable, crying for little to
no reason, or extremely tired.
Treatment for LOW blood sugar: Give SUGAR to help the blood sugar
rise. Juice boxes, Glucose tablets, and
Smarties will be kept in the nurse’s office and your classroom.
**If blood
sugar is less than 75 -> Give 3 glucose tablets, 1 package of Smarties, or 1
juice box (other sugar sources could be pixie sticks, sugar packets, non-diet
soda). After treatment, wait 15 minutes
and re-check the blood sugar. Kortnie
should not eat anything else at this time as other foods can slow the
absorption of sugar into her system. If
her blood sugar is still less than 75 repeat the steps.
LOW BLOOD SUGAR GUIDELINES
75-85 – Give 1
glucose tab or ½ package of Smarties
60-75 – Give 3
glucose tabs, 1 juice box, or 1 package of Smarties, recheck in 15 minutes
59 or less –
Give JUICE – send to Nurse’s office with her meter – SEND HER WITH A BUDDY – at
this point she may be shaky and/or confused, never leave her alone.
50 or less – it’s
better to call Miss Sharon to come to your class
**if the meter
says “LO”-give juice, call mom, and call Miss Sharon, standby with Glucagon
If UNCONSCIOUS OR HAVING A SEIZURE/OR
UNABLE TO TAKE SOMETHING BY MOUTH:
1.
Give
Glucagon (medication in red container) inject ½ into the front of her thigh
2.
Have
someone call 911 and then parents
3.
Roll
Kortnie onto her side as this medication may cause vomiting
4.
Wait 10
minutes, if not conscious inject other 1/2 of medication
High Blood Sugar: People with diabetes may have high blood
sugars and spill extra sugar into the urine on some occasions. These occasions include periods of growth,
stress, illness, overeating and/or lack of exercise, or certain
medications. High sugars are generally
not an emergency (unless accompanied by Ketones, abdominal pain, vomiting, or if
they persist for a prolonged period of a few hours). High blood sugar signs include:
1.
MILD: Thirst, frequent urination, sweet smelling breath
2.
MODERATE: Dry
mouth, nausea, stomach cramps
3.
SEVERE: Labored deep breathing, extreme weakness,
confusion, and eventually unconsciousness (coma)
*When Kortnie is HIGH- She can have a headache, be thirsty, have
to use the restroom often, and at times she can get very angry and/or throw a
fit.
Treatment for HIGH blood sugar: Call
parents for blood sugar greater than 350.
Extra insulin may need to be given by the School Nurse. Kortnie will need to drink sugar free fluids
(water) and urinate more frequently.
Please allow her to consume as much water as she wants and make bathroom
privileges readily available.
High Blood Sugar Guidelines
250 or above –
Send her to nurse’s office with meter, she may need an extra dose of insulin,
recheck in 1 hour to make sure she is coming down
350 or above –
Send her to nurse’s office WITH A BUDDY (If she is aggressive or disruptive,
have Miss Sharon, another adult, or you yourself take her out of the class.
**If her meter
says HI** she is above 600- call parents immediately – call Miss Sharon to come
to the class – try not to remove her – if she is “out of control” or disruptive
it may be better to remove the other students
When to Check Blood Sugar? 5-10
minutes before lunch, send Kortnie to the Nurse’s office with her lunch box and
test kit. She and Miss Sharon will
calculate and dose her lunchtime insulin, she will then join her class in the
cafeteria. Kortnie will keep her meter
and test kit with her at all times, she needs to be able to check her blood
sugar anytime she feels the need. If you
feel like she is acting out of character or exhibiting sings of low or high
blood sugar you may ask her to check her blood sugar at any time.
If she ever complains about not feeling
good please let her check her blood sugar or go to the Nurse’s office. If she falls asleep in class, please try to
wake her and have her check her blood sugar, chances are she is LOW. If she is crying for no reason, or seems
really angry, she is most likely having a LOW or HIGH blood sugar and will need
to be checked. Anytime she is disrupting
class please call Miss Sharon or another adult to take her out of class and
call me.
ANYTIME HER PUMP ALARMS HAVE HER GO TO THE
OFFICE AND CALL PARENTS
What should Kortnie eat or
not eat? I will pack Kortnie’s lunches and label the
items with carb counts. It is extremely
important that Kortnie eats all of the lunch I pack for her. If she does not eat all of the food she was
given insulin for she could become low within the following couple of
hours. She knows that she needs to eat
all of her lunch, but if for some reason she doesn’t finish it, she’ll need to
go to the Nurse’s office and call me. I
can help her and Miss Sharon figure out what we need to do to compensate for
the food she didn’t eat. If she brings a
snack for recess, it will be a “free” snack that she is allowed to eat without
insulin. Such as a slim jim, cheesestick,
peanuts, or sugar free jello. Also, it
is important that Kortnie is not given food without the School Nurses or
parents knowledge…she would need extra insulin or she can have a high blood
sugar in the next couple of hours. If
there are any special class parties where food will be involved, please let me
know a couple of days in advance and I will most likely come down and help in
the classroom so that Kortnie can fully participate. If other children bring birthday treats at
the end of the day, she can bring her treat home and have it for an after
school snack. If you hand out treats as
rewards, she can collect them in a zip lock type bag and bring them home for
her after school snack, or in lieu of treats you can give her stickers, or
something similar. **Last year she and
her teacher got into the routine of checking her blood sugar, then using the
teacher’s cell phone to call me and I could talk her through giving herself a
bolus of insulin when having treats**
This worked out well, if you are wanting to do something similar we are
up for it.
What to expect from
parents? I
(Amanda-mom) will always have my cell phone on my person and am fully expecting
calls from school. My phone number is
###-###-####. If you can’t get ahold of
me feel free to call her dad Brian ###-###-####. Her emergency phone list is on the first
page, just go down the list. Also, I
will accompany her on all field trips and participate in the end of the year
Track and Field Day. Please let me know
as far in advance as possible so I can make arrangements for my other children
if I need to, etc. I will provide sugar
sources for her, please let me know if/when you are running low on supplies. Always feel free to call me with any
questions! Also, feel free to email me
with non-emergent questions, class party schedules, or field trip information. absilverhorn@frontiernet.net
When to call parents
When blood
sugar is less than 60 or higher than 350
Questions on
carbohydrate counting
When Kortnie is
sick
When her pump
is alarming
If the pump
becomes disconnected or her site rips out
If Miss Sharon
is not at school
If Kortnie is
ever disruptive
With ANY
concern at all
Giving Insulin
When Eating
1. Check Blood Sugar
2. On Meter/Remote BOLUS will be highlighted,
press OK
3. Use down arrow key to highlight EZCARB,
press OK
4. Add in total carb count using up arrow key,
when total is input press OK
5. ADD BG will be highlighted, press OK
6. Blood Sugar
# should be showing, press OK (if not use up or down arrow keys to input
blood sugar number, press OK
a.
If a
high or low blood sugar was input, you may get a Pump Alert screen, CONFIRM
will be highlighted, press OK
7. SHOW RESULT will be highlighted, press OK
8. Look on 4th line where it says
TOTAL = xxx, this is the total number of insulin units to give Kortnie
9. Use the up arrow to put in total number,
press OK
10. GO will be highlighted, press OK and
insulin will be delivered
When High Blood Sugar
1.
Check Blood Sugar
2.
On
Meter/Remote BOLUS will be highlighted, press OK
3.
Use
down arrow key to highlight EZBG, press OK
4.
Blood
Sugar # should be showing, press OK (if not use up arrow keys to input blood
sugar number, press OK)
a.
If a
high blood sugar was input, you may get a Pump Alert screen, CONFIRM will be
highlighted, press OK
5.
SHOW RESULT will be highlighted, press OK
6.
Look
at the 3rd line where it say TOTAL = xxx
7.
Use up
arrow key to put in TOTAL number, press OK
8.
GO
will be highlighted, press OK to deliver insulin
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