Triage phone service update
Here's an updated Triage help sheet with some important information for our families.
Please remember the Triage phone service is for families of children with diabetes to support acute management between clinic appointments. This service should be used for those who are acutely unwell. This number should not be used for obtaining regular advice.
Our Triage phone line is 6456 1111 and is available Monday to Friday 08.30am - 16.30pm
Our priority for this service is to support families of children in need of urgent medical support related to their diabetes. While we will always do our best to help you, we have recently been receiving an extremely high number of calls which means it becomes challenging to help those most in urgent need of support and medical advice.
Families also have access to a doctor by telephone for emergency diabetes assistance available 24 hours per day, though please remember these doctors are also working on the wards, in clinics and on-call during the day. They are always there to assist you with emergencies and urgent issues by phone, or to communicate with the hospital if your child needs to be seen overnight.
May we ask that, before calling triage, please consider the following:
Unwell Child
Please have a record of glucose levels and ketones levels at hand when you call.
If your child has positive ketones (i.e. above 0.6mmol/L) state on the answer phone message ‘child is sick with ketones’ your call will be prioritised based on this.
If child is sick with negative ketones, (i.e., below 0.6mmol/L) you may be able to manage by implementing your sick day guidelines. These can be found in Chapter 7 of, the new patient folder.
Remember to manage symptoms with regular analgesia and make an appointment with GP (General Practitioner) if necessary
If you are concerned or require immediate support for managing challenging blood glucose levels;
Call Triage 6456 1111 option 2 8.30am-4.30pm (Mon -Fri)
Or out of hours – Emergency on-call Doctor 6456 5993
Hypoglycaemia (Low blood glucose)
URGENT: Child unable to swallow or too drowsy to take anything orally
Give Glucagon injection as taught, if not available or you require emergency support call 000
Once your child is alert contact triage to discuss preceding events and obtain new prescription for replacement Glucagon
Non-Urgent
Have you confirmed hypoglycaemia with a finger prick, or is child symptomatic?
Treat as per hypoglycaemia guidelines with oral glucose. If unsure about management; Refer to Chapter 4 in the the new patient folder
Patterns of hypoglycaemia
Implement insulin adjustment guidelines
Hyperglycaemia (High Blood Glucose)
If you use a CGM (Continuous Glucose Monitoring) device (a “sensor”), has your Time in Range (Time spent between 3.9-10 mmol/L) dropped below 70%, or have you noticed a pattern of hyperglycaemia. If so, you should implement the insulin adjustment guidelines: or ask for some non-urgent support from your regular clinical team who know you and your child best.
Review after 3 days, if no improvement, adjust further if confident or contact triage for support.
Technology
Pumps:
- Are you new to insulin pump therapy and require an adjustment of settings?
Leave detailed message, with your name, child’s name, phone number, and state: ‘new pump review’
- Need assistance with pump rate adjustment? Have you uploaded the pump? If not please do so before calling triage
Have a copy of the appropriate age guidelines with you when talking to triage. If you feel confident to make changes using the guidelines do so.
Review changes made in 3 days. If no improvement contact triage for support.
- Pump failed?
Implement Pump Failure Guidelines.:
Contact pump supplier for support,
Dexcom/AMSL Helpline: 1300 851 056
Medtronic Helpline 1800 668 670
Yspomed Helpline 1800 447 042
Omnipod Helpline: 1800 954 074
- Pump due an upgrade?
Access the pump application forms,
complete form and hand in and your next clinic appointment or email through to
pchdiabetestriage@health.wa.gov.au
CGM:
DEXCOM:
Signal Loss, question mark, calibration error sensor failed:
https://www.dexcom.com/en-AU/faq-search-page
Sensor True Fail:
Dexcom/AMSL Helpline: 1300 851 056
MEDTRONIC:
Medtronic Helpline: 1800 668 670
FREESTYLE LIBRE: 1800 801 478
Other things to consider
Changing appointments:
These cannot be actioned via the triage line, so please select option 1 when calling and this will take you through to the Diabetes Outpatient Clerks who manage all scheduling issues. It is highly likely your clinic team will want to help you ensure you can see them, but the clerks may need to speak to your diabetes team to ensure they can see you at another time.
Prescriptions:
The triage line is staffed by diabetes nurse educators who can provide dosing advice and sick day management advice but cannot write prescriptions for insulin. If you have lost your prescription or were unable to attend your last clinic appointment, please use your GP who can provide interim short-term prescriptions for insulin until your next diabetes clinic appointment.
Driver’s License Applications:
These cannot be managed by the triage phone line and are important legal documents. If you are planning to apply to apply for your Driver’s license, please bring your form along to your next clinic appointment where the endocrinologist will complete the assessment which needs to be done in person
Reasonable call back times:
Our priority is to serve our patients and families with the most urgent medical concerns. Please bear this in mind when awaiting a call-back, as there may be a minor delay whilst we support families with acutely unwell children.
If you are concerned about your child or require immediate support with diabetes
call triage 6456 1111 option 2 8.30am-4.30pm (Mon -Fri)
Out of hours – Emergency on Call Doctor 6456 5993