UT Diabetes-emergency action plan 2018-2025 free printable template

DIABETES Emergency Action Plan (EAP) Utah Department of HealthSchool Year:STUDENT INFORMATION Student: DOB: Grade: Parent: Phone(s): Physician: Phone: School Nurse: School Phone: When Blood Glucose

How to fill out diabetes action plan pdf form

How to fill out diabetes emergency action plan:

1. Gather all necessary information about your diabetes and medical condition. This includes details about your medications, doses, and emergency contacts.
2. Fill out your personal information, such as your name, date of birth, and contact details, on the action plan form.
3. Provide accurate information about your diabetes diagnosis and any relevant medical history.
4. List your current medications, including the names, doses, and administration instructions.
5. Include any allergies or adverse reactions to medications or medical treatments.
6. Specify your healthcare provider's contact information and any other medical professionals involved in your care.
7. Indicate emergency contact information, such as family members or friends who should be contacted in case of an emergency.
8. Include detailed instructions on how to manage your diabetes during an emergency. This may involve describing specific actions to take, like checking blood sugar levels, administering insulin, or taking oral medication.
9. Provide any additional information or special instructions that emergency responders should be aware of, such as if you have an insulin pump or continuous glucose monitor.
10. Review and update your diabetes emergency action plan regularly, especially if there are any changes to your medications, healthcare team, or emergency contacts.

Who needs diabetes emergency action plan:

1. Individuals with diabetes, regardless of their type (type 1, type 2, gestational, etc.), should have a diabetes emergency action plan.
2. Anyone who requires insulin or other diabetes medications to manage their blood sugar levels should have a diabetes emergency action plan.
3. People who have experienced hypoglycemic episodes or other diabetes-related emergencies in the past should have a diabetes emergency action plan.
4. Individuals who may require assistance or support during a diabetes emergency, such as young children, older adults, or those with cognitive impairments, should have a diabetes emergency action plan.
5. Family members, friends, or caregivers of individuals with diabetes may also benefit from understanding and having access to a diabetes emergency action plan in case they need to assist in an emergency situation.

People Also Ask about utah action form

How do I create an action plan for diabetes?

Pay attention to carbohydrates and sugars, letting yourself have the occasional treat without overindulging. Make a goal to eat more fruits and vegetables and less sodium and fat. Try to eat your meals at the same time each day to keep your blood sugar levels steady.

What are examples of diabetic emergency?

Signs and symptoms rapid pulse and breathing. fruity, sweet breath. excessive thirst. drowsiness, leading them to become unresponsive if not treated (also known as a diabetic coma)

What is considered a diabetic emergency?

Diabetic ketoacidosis, or DKA, is a life-threatening emergency caused when you don't have enough insulin and your liver has to break down fat into ketones for energy, but too fast for the body to handle. A buildup of ketones can change your blood chemistry and poison you. You could fall into a coma.

What are 5 signs of a diabetic emergency?

What are the signs and symptoms of a diabetic emergency? hunger. clammy skin. profuse sweating. drowsiness or confusion. weakness or feeling faint. sudden loss of responsiveness.

What should a diabetic care plan include?

It should include medications, if needed, an eating plan and how to work in physical activity to your day. It may also include what to do if you're not getting to your blood sugar targets. manage your diabetes. Each medication helps manage blood sugar levels in a different way.

What are the three main diabetic emergencies?

5 Most Common Diabetic Emergencies Heart Attack. People suffering from diabetes are at a greater risk of heart attack as compared to others. Kidney Failure. Diabetes impacts kidneys as well and is a leading cause of kidney failure amongst many diabetic patients. Vision Loss. Hyperglycemia. Hypoglycemia.

What is a diabetic action plan?

This action plan is a guide to help you manage the signs and symptoms of diabetes. You and your provider should complete this plan together at your next visit. The three colors (zones), green, yellow and red, help you decide what to do. Zone. GREEN.

Which of the following is the more common diabetic emergency?

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS; or hyperosmolar non‐ketotic hyperglycaemia) are the most common and most serious diabetic emergencies. Most of these occur in patients with known diabetes.

What are common diabetic emergencies?

In this article, we focus on five diabetic emergencies: 1) diabetic ketoacidosis (DKA); 2) hyperosmolar hyperglycemic state (HHS); 3) hyperglycemia without obvious acidosis; 4) hypoglycemia; and 5) other selected medical emergencies in diabetes.

How do you write a smart goal for diabetes?

Eat regular, well-balanced meals (and snacks if needed). Target: 30 minutes of moderate exercise 5 days per week (a total of 150 mins/week). Include muscle and bone-strengthening activities 2 days per week. I will take my medications each day the way my health care provider and I discussed.

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What is UT Diabetes-emergency action plan?

The UT Diabetes-emergency action plan is a set of guidelines designed to assist individuals with diabetes in managing their condition during emergencies, ensuring they receive appropriate care and support.

Who is required to file UT Diabetes-emergency action plan?

Students and staff with diabetes who may need assistance during emergencies are required to file the UT Diabetes-emergency action plan.

How to fill out UT Diabetes-emergency action plan?

To fill out the UT Diabetes-emergency action plan, individuals must provide personal information, details about their diabetes management, emergency contact information, and any specific instructions needed during a diabetes-related emergency.

What is the purpose of UT Diabetes-emergency action plan?

The purpose of the UT Diabetes-emergency action plan is to ensure that individuals with diabetes have a clear and actionable plan in place for managing their condition effectively and obtaining the necessary medical attention during emergencies.

What information must be reported on UT Diabetes-emergency action plan?

The UT Diabetes-emergency action plan must include information such as the individual's name, type of diabetes, medication regimen, emergency contacts, and any specific medical instructions.