In our hospital the Endocrinologist on-call has to deal with her in the event he refuses (it does happen) I would phone the patient, talk to her about her symptoms eg thirst, urinating, breathlessness. Ask her to do a CBGM (she should have a monitor). Tell her to come to the ER immediately if symptoms and CBGM in keeping with incipient DKA and not to drive herself. Phone ER Triage to let them know she is en route.
If she did not answer Medical records has a second contact number. I would phone that. If they did not respond I would phone the police and ambulance and tell them the details and the risk to the patient.
Then I would document everything in the little book I carry with me. I would also phone back the technologist to explain what I did, and also have them document it in the LIS
Elizabeth Mac Namara
Jewish General Hospital
On 2012-01-31, at 5:07 AM, "Robert Lord" <[log in to unmask]> wrote:
> Hello
>
> An on-call scenario
>
> 7pm called by BMS from lab
>
> 21 yr old patient had attended diabetic clinic at the hospital last thing in the afternoon
>
> Glucose = 36
> HbA1c = 114 mmol/mol
>
> Clinical details 'Type 1 DM'
>
> No previous glucose result but 2 previous high HbA1c results.
>
> Not registered with a local GP.
>
> I'm interested in what others, faced with this scenario, would do!
>
> Many thanks
>
> Rob
>
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