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事件摘要。P先生，56歲，患有1型糖尿病30年，於36小時前因糖尿病酮酸中毒入院；糖尿病酮酸中毒(DKA)已於昨晚解決，他目前接受基礎-餐前皮下胰島素治療方案。他的肌酸酐為0.9 mg/dL。在電子健康紀錄(EHR)系統中斷期間，針對0400血糖286 mg/dL開立了一次校正劑量醫囑；醫囑者原意為常規胰島素10單位，而紙本醫囑寫著「10U」。具有六個月經驗的夜班護理師在0430給予了常規胰島素100單位。0500時，P先生出汗、顫抖、意識模糊，血糖為38 mg/dL。因為他有暢通的靜脈注射且無法安全吞嚥，依醫囑給予靜脈葡萄糖；升糖素仍備用。0515時，他意識清醒且定向力良好，血糖現在為124 mg/dL，且在室內空氣下血氧飽和度(SpO2)為98%。他的下次血糖檢查在0730是單位常規，且他的餐前胰島素預計在0800給予。他的女兒在床邊。