Version 2.73

74150-4Diabetes Type I action planActive

Part Description

LP173733-9   Diabetes type I action plan
The "Type I Diabetes Action Plan" is a communication tool medical providers use to inform school staff of a patient's diabetic condition and treatment protocol. School staff uses this Information to guide and authorize their treatment of the child's diabetes while at school. The following information is included in the action plan: 1. Patient Information: name, dob, , grade, date diabetes diagnosis, 2. Contact Information: parent/guardian, address, phone numbers, 3. Students Health Care Provider: provider and clinic names, phone numbers 4. Emergency Contact: name, relationship, phone numbers, 5. Blood Glucose Monitoring: target range, times to check blood glucose, if student can do checks self, type of blood glucose monitor, 6. Insulin: if insulin at school or not, type of insulin, insulin doses: school, lunchtime, meal bolus: units/grams carbo, correction: units per md/dl over mg/dl (correction scale), if parents provide written, 7. Student's role in management of their diabetes (check skills present): basic skills, syringe/pen skills, insulin pumps, oral medications, 8. S/S abnormal blood sugars checklist, 9. Actions for Low Blood Sugar dependent on measurement and/or consciousness,10. Actions for High Blood Sugar,11. Daily School Routines/Classroom Information/Accommodations: checklist re lunchtime & snack carbs, access drinking water, bathroom privileges, recess time, physical education, 12. Extra Snacks/Parties: checklist re treats in classroom, 13. Students who ride the bus: if low,14. Students who drive: if low 15. Field trips: check list,16. Equipment and Supplies: list, and 17. Acknowledgment: provider signature and date, parent/guardian signature and date. Source: Southeast Minnesota Beacon Community

Fully-Specified Name

Diabetes type I action plan

Additional Names

Short Name
Diabetes type I action plan

Basic Attributes

First Released
Version 2.46
Last Updated
Version 2.54
Change Reason
Based on Clinical LOINC Committee decision during the September 2014 meeting, {Provider} was changed to {Author Type} to emphasize a greater breadth of potential document authors. At the September 2015 Clinical LOINC Committee meeting, the Committee decided to change {Author Type} to {Role} to align with the 'Role' axis name in the LOINC Document Ontology.
Order vs. Observation

Member of these Groups

LG41826-5 {Setting}|ANYTypeofService|ANYKindofDocument|ANYRole|ANYSubjectMatterDomain

Language Variants Get Info

zh-CNChinese (China)
it-ITItalian (Italy)
Diabete tipo 1, piano d'azione:Osservazione:Pt:{Setting}:Doc:{Role}
es-MXSpanish (Mexico)
Plan de acción para la diabetes tipo I:Tipo:Punto temporal:{Configuración}:Documento:{Role}

LOINC FHIR® API Example - CodeSystem Request Get Info