0515 event summary. Mr. P, 56, has had type 1 diabetes for 30 years and was admitted 36 hours ago with diabetic ketoacidosis; the DKA resolved yesterday evening, and he now receives a basal-bolus subcutaneous insulin regimen. His creatinine is 0.9 mg/dL. During an EHR outage, a one-time correction dose was ordered for a glucose of 286 mg/dL at 0400; the prescriber intended regular insulin 10 units, and the paper order read "10U." The night RN, who has six months of experience, gave regular insulin 100 units at 0430. At 0500 Mr. P was diaphoretic, tremulous, and confused with a glucose of 38 mg/dL. Because he had a patent IV and could not safely swallow, prescribed IV dextrose was given; glucagon remained available. At 0515 he is alert and oriented, the glucose is now 124 mg/dL, and SpO2 is 98 percent on room air. His next glucose check at 0730 is the unit routine, and his mealtime insulin is due at 0800. His daughter is at the bedside.
0515 event summary. Mr. P, 56, has had type 1 diabetes for 30 years and was admitted 36 hours ago with diabetic ketoacidosis; the DKA resolved yesterday evening, and he now receives a basal-bolus subcutaneous insulin regimen. His creatinine is 0.9 mg/dL. During an EHR outage, a one-time correction dose was ordered for a glucose of 286 mg/dL at 0400; the prescriber intended regular insulin 10 units, and the paper order read "10U." The night RN, who has six months of experience, gave regular insulin 100 units at 0430. At 0500 Mr. P was diaphoretic, tremulous, and confused with a glucose of 38 mg/dL. Because he had a patent IV and could not safely swallow, prescribed IV dextrose was given; glucagon remained available. At 0515 he is alert and oriented, the glucose is now 124 mg/dL, and SpO2 is 98 percent on room air. His next glucose check at 0730 is the unit routine, and his mealtime insulin is due at 0800. His daughter is at the bedside.