Friend of mine was almost killed by docs in the ER

[jjesusfreak01]

So, a friend of mine had let me know she had been in the hospital the other day, and I was visiting her today and asked what she was there for...

Background: My friend is a 20yo female, she is diabetic and uses an insulin pump + supplemental insulin when necessary to control her blood sugar. She probably weighs 100lbs.

She had apparently become really sick in the last week to the point where she was having problems controlling her blood sugar (sitting over 400), which was only compounding the problem. She and a friend checked her in to the ER of the hospital on campus (we have a medical school, so there is a large teaching hospital here).

She mentioned that she was in lousy shape when she got to the hospital, but that she had gotten a whole lot worse after she had been in the ER for a while. I asked what the specific problem was, and she said DKA...

At this point I was quite confused. I was thinking of the obvious problem, "how can someone on an insulin pump go into DKA?" Well, after some prodding, I got the answer. The doctor at the hospital had told her to turn off her insulin pump, with the implication that they would monitor her blood sugar and treat accordingly. Guess what, they didn't, and she went into DKA in a hospital ER.

So, that's the story. I want to go yell at the idiots in the ER, but I won't because her mother is a nurse and already did so. Oh, and she's got marks all over the bottom of her wrists and top of her hands, because apparently nobody there is capable of getting arterial or venous lines in the first 5 sticks.

Note: Hospital name unlisted to protect the guilty, though if you figure out what college I went to, you'll know what hospital.

Sorry if I come off a little angry...its because I am angry right now.

 

[Shishkabob]

So... it's the doctors fault that the nurses supposedly didn't do glucose checks like that were supposed to?

 

[Aidey]

Doesn't DKA need more than a couple of hours to develop? I can see how if her CBG was already running high, she might have been 1/2 way there already, but that still doesn't seem like enough time.

I'm also not shocked they told her to turn it off. She is there because her CBG is off, they would want to control as many variables as possible to help rule out causes (pumps can malfunction).

 

[abckidsmom]

Doesn't DKA need more than a couple of hours to develop? I can see how if her CBG was already running high, she might have been 1/2 way there already, but that still doesn't seem like enough time.

I'm also not shocked they told her to turn it off. She is there because her CBG is off, they would want to control as many variables as possible to help rule out causes (pumps can malfunction).

+1

A type 1 diabetic under stress of illness or anything else can just do crazy things with the sugar.

The ER is a terrible place to try and manage blood glucose, but leaving her on the pump is not a good answer at all.

I am sorry your friend was so sick. Hope she's doing better.

 

[ERMedic]

Yeah, it takes several hours to develope. Not a short period of time like hypoglycemia.

 

[jjesusfreak01]

To clarify, she was in the hospital for about a day. She went in with hyperglycemia, turned off her insulin pump, and developed DKA sometime during her stay, but she was there long enough that at one point they tried to move her to the ICU (couldn't find an open bed though).

Honestly, I can understand why they would ask her to turn off the insulin pump, but its just frustrating because if she hadn't then there probably wouldn't have been a problem.

@Linuss
Hard to say. Since her CBG shoots up when she gets sick, she should have been getting both regular glucose tests and insulin shots. The fact that they apparently did neither is the problem, and even if the nurses weren't following doctors orders, the doctor evidently wasn't checking up on their patients.

PS: She was doing just fine today.

 

[Aidey]

So she had the pump off for a day? Or it was a day before they asked her to turn it off?

 

[jjesusfreak01]

So she had the pump off for a day? Or it was a day before they asked her to turn it off?

She went into the ER because she was sick (cold or some other virus...generically sick), which threw off her blood sugar to the point she couldn't keep it in line and the high blood sugar was just making her worse. When she was placed in a bed in the ER, the doc asked her to turn off her insulin pump. After it had been off for an unknown (to me) amount of time, she went into DKA due to apparent lack of care by the ER docs and nurses.

 

[Silver_Star]

Its weird that they didn't bother to monitor her blood sugar. I was friends with someone who was a diabetic and developed DKA from being ill. I sat with him in the ER for a long friggin' time. Just about every 10 minutes or so someone would come in and stick him to either take blood or check out his blood sugar.