504 For child’s Name School Year School Year Juvenile

504 for child’s name school year school year juvenile diabetes or type 1 diabetes 1. child wears an insulin pump

504
For
School Year
Juvenile Diabetes or Type 1 Diabetes
1.
wears an Insulin Pump for his diabetes. must be
dosed for all food and sugary drinks taken in accordance with the
dosage chart provided by the parents. (Parents may change dosage
chart at any time) Students will be instructed not to touch the
pump or it’s tubing at any time for any reason.
2.
Parents shall provide meter, test strips, lancing device and
lancets, ketone sticks, gloves, sharps container for disposal,
emergency Glucagon, and pump supplies, syringes and insulin for
emergency dosing for the nurses office. For the classroom, parents
shall provide meter, test strips, lancing device and lancets,
gloves, sharps container for disposal, glucose tabs and snacks for
treating hypoglycemia. The classroom supplies will be in the same
room (or on the playground) with at any time. (Lincoln
Public Schools will allow snacks in the classroom, but if the
child is not capable of testing themselves with Teacher/Adult
interpreting numbers, then the only supplies needed for the
classroom would be snacks and glucose tabs and/or gel) It will be
taken on field trips, fire alarms/drills, tornado alarms/drills,
or at any other time leaves any area.
3.
Lancet will be changed in the lancet device once daily, with the
used lancet being placed in the sharps container.
4.
will be allowed in-room testing. ( Public
Schools only allows this if the child is capable of conducting the
test himself. Teacher/Adult must interpret the numbers. Otherwise
the district requires testing in the Nurses office.) Testing must
be done at anytime child is acting low, see chart, or complains he
feels low. All teachers comes in contact with will be
trained in this testing. is capable of testing himself
with supervision, with adult interpreting blood glucose numbers.
If the numbers require, correction or snacks will be given in
accordance with dosage chart provided. Numbers and any corrective
action will be recorded in log book provide. Log book will come
home and return daily to school with . The goal is to
minimize disruptions in regular school schedule and
minimize time away from the classroom.
5.
Blood sugar testing must be done before any testing and fall in
normal ranges, . If
numbers are not in range, testing must be held off until
corrections have been made according to provided instructions.
(Parents may change these instructions at any time.) He will be
given time for blood sugar correction to take place without
penalty. He will be allowed the same time allotted to the other
students for the testing.
6.
Blood sugar must be tested before gym class, and needs to have
numbers from for
participation. If he is below the 125, a snack must be given
according to instructions. After snack, he may participate as
normal. If he is over 240, test for ketones. If no ketones are
present, he may participate as normal.
7.
If behaves in a manner that is out of character (i.e.,
disrespectful/ belligerent/ defiant; hard time staying in his
seat; sleepy, lethargic) then his blood sugar must immediately be
taken. Blood sugar level should fall within normal range before
any disciplinary action is taken.
8.
will be allowed unlimited access to water and the
bathroom.
9.
will be allowed snacks anytime and anywhere as blood
sugars dictate.
10.
will not be penalized in anyway for missing school or
tardiness related to his diabetes (medical appointments, illness,
or time necessary to maintain blood glucose control). ’s
diabetes will not prevent him from participating in any class
activity or field trips.
11.
Parents must be contacted for any of the following reasons:
infusion set comes out (insulin pump no longer connected
to his body), his pump alarms and cannot be remedied, his blood
sugar is less that 50, his blood sugar is less than 75 on two
consecutive readings, his blood glucose exceeds 300, his blood
glucose exceeds 250 on two consecutive readings, if ketones are
present.
12.
Glucagon will be administered in accordance with Doctors orders.
13.
Parents will provide a mandatory teaching session to homeroom
teacher, specials teachers, Nurse and Para, and all other staff
deemed appropriate. Parents will review this instruction at
semesters end. A copy of the health care plan, and instruction
sheets will be provided for each room by parents.
Emergency Contacts
Parents home work cell
home work cell
Other Emergency Contact home work cell
Doctors’ Numbers
Pediatrician office
Endocrinologist office