Monday, December 9, 2013

Emergency Room ignorance

In our diabetes world, there are few things that will strike fear into my heart more strongly than the awful combination of a stomach virus, low blood sugars, and high ketones. I can handle a lot...lows, highs, colds, pink eyes, ear infections, even broken bones and bee stings. I can handle pizza, birthday parties, sleepovers, and hormones. I can handle pumps and needles...finger pokes and blood sugars...carb counting and temp basals. I can do it. For the most part, these things have become second nature to me now. But the dreaded low blood sugar, high ketones, and vomiting combination platter....sigh...well, lets just say it scares me more than spiders...and if you knew me, you'd know that's a whole lot of fear right there.

Last Saturday started out like normal, we had dressed...went to gymnastics class. With about 10 minutes left of class, Emma came running up the bleachers to tell me she didn't feel well...she had to throw up. I had instant chest pains, my palms started sweating, and my mind went into overdrive panic mode envisioning her throwing up all over the other parents sitting below us. Well, to make a long story short, I got her to the washroom and she threw up...sweat was pouring off her face...and she looked like she had been hit by a transport truck. We made our way home and settled in on the couch for the old familiar routine of checking blood sugars, ketones, and trying our best to keep her hydrated.

After almost six years of raising a child with type 1 diabetes, you kind of develop a sixth sense for knowing when it's time to wave the white flag and head down to the emergency room for some help. I tried my best at home, but it just wasnt working...she needed an IV. So, we packed everything up and headed down to the hospital.

I hate the hospital for a number of reasons...since diabetes came into our lives, the main reason though is because I have witnessed first hand just how little the emergency room staff know about type 1 diabetes. It's shocking to me really. I mean I get that they are not specialists...they haven't specifically studied type 1 for a length of time I'm sure. I am assuming that they are kind of a jack of all trades, so to speak. They need to be prepared for any situation that may come through those doors. I get that. I respect that. I admire it...because I know it took a lot of hard work, intelligence, and determination to get where they are today.

BUT....and yes, this is a big but....I believe there is an unacceptable lack of knowledge about even the basics of type 1 diabetes. In my experiences, I have had emergency room nurses argue with me that I did not need to know the carb count of the food Emma eats...but rather the calories. I've had other ER nurses, try to give Emma double the insulin she needed. I've had ER doctors forget about us in the acute care area of the ER for not just an hour or two....but SEVEN hours...he forgot we were there...just plumb forgot. I've had to follow a nurse around the ER begging her for some anti-nausea meds for Emma because she had been throwing up non stop for the entire seven hours we had been in the room of forgotten patients. I've had triage nurses yell at me to not give my child ginger ale when her blood sugar was dangerously low while we sat there waiting to be seen. Needless to say, I gave it to her anyway...I wasnt about to let my child pass out because of a yelling nurse. And last Saturday night, I had the ER doctor actually ask me if Emma's insulin pump monitors everything for we don't have to do anything. wish, but no.

So, I am aware of this ignorance in the ER...I know not to trust them...not to leave my child alone with them...not to believe them all the time or give them my full trust...because every single time I've had to take her there, I've encountered unacceptable levels of ignorance about her disease. The thing that terrifies me the most though, is the newly diagnosed family that may walk through those doors. The family that is still kind of naive...still trusting...still believes all doctors and nurses know what they are talking about all of the time. It scares me.

I plan on doing something to rectify this situation. I plan on pushing for at least the basics to be re-taught to the ER staff. If I have to do it myself, I will. The way things are right not's not acceptable...and it must be fixed.


  1. This is so true. I have tried desperately to avoid the ER in the 10 years that my daughter has been diagnosed. I am happy to say we only had to go once in that 10 years and it wasn't really necessary even then. They sent us back home. I do not trust the ER at all. Too many horror stories about the lack of basic understanding of T1 there.

  2. I have heard stories from friends, but thankfully we have avoided the ER for the most part. We, as the parents, need to stand our ground and do what we know is best for our CWD. Thankfully, our endo is 100% on my side, and the only time I had an issue in the ER (our first time, Elise was 18 months), I told the doc to call our endo and she would vouch for me. Our doc put her in her place and the rest of our time there, I called the shots diabetes-wise.

    Great post and good for you!

  3. Hello, friend of Brenda's here. I can assure you not all ERs are like this. Are you near a larger hospital with a childrens designation? A university center? While the waits may be longer for minor things, every place I have worked treats Type 1 children exigently as they should be. It is a standard part of ER training...were teh ER docs at your hospital residency trained? How much prior experience working with children?

    1. That is great to hear not all ER's are like that Doc! Our hospital is not small by any means...but it's not a children's hospital or a university centre. We are about an hour away from either of those. Unfortunately I don't know how the docs at our ER were trained...or even if they were trained sufficiently on type 1. In my experiences, I would emphatically say they knew very little about it....not even the basics. That's really what concerns me, I don't expect them to know all the fine details...I just would appreciate if they knew the basics.