GIRFT interactive pathways

Essential safety checks to prevent diabetes related harms arising in ED and acute admissions units

Acronym for remembering the 5 essential checks

SNACK and TICKLE (Think Insulin, Check Ketones, Look at feet, Examine for loss of protective sensation

Hypoglycaemia

Snack

should be provided for insulin and SU treated patients to prevent hypo in the department

DKA in Type 1 DM

Think Insulin

A TIME CRITICAL MEDICINE 
doses must be given on time to prevent DKA and subsequent doses  prescribed particularly basal insulin

DKA and SGLT-2 Inhibitors

Check Ketones

in all on SGLT-2i and do not continue if unwell

Foot ulcer / infection

Look

at the bare feet – foot infection is a common cause of systemic sepsis

Foot pressure ulcer

Examine

for loss sensation
= high risk of pressure ulcer

The Ipswich Touch Test is a 30 sec. screening tool.
Click here to see video >