Ocean Springs School District
Plan of action for ___________________________________ regarding diabetes activity during bus transportation.
Type I Diabetes (with/without pump) – is an auto immune disease that occurs during childhood. The immune system attacks the beta cells (the insulin-producing cells of the pancreas) destroying them. Daily insulin is necessary for survival. Food intake, activity levels and insulin controls diabetes.
***An extremely low blood sugar/high blood sugar can be life threatening and can become an emergency situation quickly. Do NOT delay responding.
ACTION: STEPS TO TAKE DURING HYPOGLYCEMIA/HYPERGLYCEMIA (LOW/HIGH BLOOD SUGAR)
1.
Identify symptoms/problems (listed below):
Have student check blood sugar (if possible) with meter in backpack and treat appropriately.
<_____ (low) or > _____ (high). ***Physician- please fill in***
***Low blood sugar – student needs to have snack/juice/glucose tablets/icing immediately – repeat blood sugar test in 15 minutes if below 100, and provide additional snacks if needed.
If Urgent/Emergent – Do not try to give anything by mouth, position on side, call 911. Contact
Parents
***High blood sugar – water bottle if mild symptoms. Call 911 and parent if Urgent/Emergent.
All critical numbers ( >____ or <____ ) ***Physician- Please fill in.***– need to be reported to parents.
If possible – stop at nearest school in city to receive assistance from School Nurse.
LOW BLOOD SUGARS
Mild Symptoms Urgent (Call 911) Extreme Emergency (Call 911)
Severe confusion
Blurred Vision
Slurred Speech
Extremely poor coordination
Disorientation
Not able to / unwilling to swallow
May be combative
Seizures
Loss of Consciousness
Inability of Swallow
Headache Sweating
Dizziness Pale
Tired/Drowsiness
Inability to concentrate
Poor coordination
Shakiness/Weakness
Irritable/Personality change

Ocean Springs School District
HIGH BLOOD SUGARS
Mild Symptoms Moderate Extreme Emergency (Call 911)
Extreme thirst Hunger
Nausea Pale
Hyperactivity Headache
Stomachache Vomiting
Fatigue/Sleepiness
Blurred vision
Lack of concentration
Sweet, fruity breath
Frequent Urination
Mild Symptoms +
Dry mouth
Nausea
Stomach cramps
Vomiting
Labored Breathing
Very Weak
Confused
Unconsciousness
***If 911 is contacted, the bus driver or aide will contact OSSD Administration and the child’s parents at the number listed below.***
EMERGENCY PARENTAL CONTACTS:
1.
____________________________ Relationship: _______________ Phone: _______________
2.
____________________________ Relationship: _______________ Phone: ________________
Physician Special Instructions:
______________________________________________________________________________________
______________________________________________________________________________________
I agree with this plan and give permission for school personnel to contact emergency medical services, if necessary. ***
.***
Parent Signature: ________________________________________ Date: __________________
Physicians Signature: _____________________________________ Date: ___________________
***Physicians – please fill in high/low blood glucose perimeters above.***
Ocean Springs School District: ______________________________ Date: ___________________

Ocean Springs School District
*** Appropriate Snacks to provide for low blood sugar:
(Provide quick sugar source) – Give only (1) initially.

3-4 glucose tablets
 4 oz juice
 6 oz regular soda

3 tsp of glucose gel
Moderate Symptoms – Give quick sugar source from previous list, and add a carbohydrate and protein (ex: Peanut butter crackers/Cheese crackers).
Urgent/Emergent Symptoms – Don’t attempt to give anything by mouth. Position on side, if possible. Call 911 and
Administrator and Parent.