Diabetes Type 1 with Acute Illness Clinical Pathway — Emergency Department
Diabetes Type 1 with Acute Illness Clinical Pathway — Emergency Department
Initial MD/APP/RN Team Assessment
History
- Home glucose levels
- Home urine or blood ketones
- Total daily insulin dose, recent doses
- Insulin pump
- Other symptoms
Physical Exam
- Vital signs
- Brief neurologic assessment
- AVPU/GCS
- Pupils
- Respiratory distress
- Perfusion
- Capillary refill
- Pulses
RN Bedside Procedure
General
- Place patient on CR monitor
- Begin documentation on DKA flowsheet
- Blood glucose every 2 hours
- POC glucose and BOHB every 2 hours, notify FLOC with results
- I/O hourly
- VS hourly (document in computer)
- Insulin dose, time given
IV Placement
- Discuss the need for IV placement with patient/family, obtain the following specimens:
- Bedside glucose
- Basic metabolic panel