Does your BLS protocal incl. glucose monitor finger-stick?
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JPINFV
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I've never bought the entire, "Well, if it can be taught to lay people, why can't we do it?" line of reasoning. In the quoted part of my last reply, it looked like you were invoking that argument. Besides, not all emergency calls start in houses or businesses. What happens when you get called to the vent dependent patient at the local nursing home?
reaper
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You do understand that there are thousands of pt's on vents at there homes. If you are called to transport as a basic, do not take them off the vent, unless there is a malfunction. You can unplug the vent and transport with pt. You can plug the vent back into power, in the truck. If the settings get changed, have a family member assist you with it. They have more knowledge of the vent then you do.
JPINFV
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Not all home vents will fit in the ambulance. Of course that was why, at my old company, there were RTs on staff.
WolfmanHarris
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Common sense? Umm no. Common sense is not touching a hot stove, or not stacking fragile things in an upside down pyramid. I think you're talking about clinical judgment, which requires education and honing.
[YOUTUBE]http://www.youtube.com/watch?v=G2y8Sx4B2Sk[/youtube]
The line of reasoning is more along the lines of, if lay people can be taught how to do it, why can't we be taught how to do it if it provides a benefit and carries little risk to the patient? In the case of BGL monitoring, there is little downside, and only benefit. The only legitimate argument I can see is a cost vs. benefit argument.
Vent dependent patient: A. What was I called for? B. Why wasn't ALS at least dispatched as well. C. I would call Medical Control anyway.
Vent dependent patient: A. What was I called for? B. Why wasn't ALS at least dispatched as well. C. I would call Medical Control anyway.
JPINFV
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Why can't basics be required to take an actual anatomy and physiology course? (for that manner, why aren't paramedics required to take a real A/P course?) Now that would go a lot further in me feeling comfortable with expanding the score of practice for basics.
Sure, the system needs to be revamped. (Not this thread) I still don't see how knowing A&P would change anything in relation to taking a BGL measurement. Knowing A&P doesn't change glucose levels, nor the need or lack of a need for oral glucose. This isn't really expanding the scope of an EMT-B's responsibilities, it is giving them a tool to narrow a responsibility they already have. No basic is about to stick a patient and push D50, but if someone needs glucose, even if they aren't diabetic, we should be able to administer oral glucose. I guess that's technically an expansion, but I don't think its anything that puts patients at risk.
We could go on and argue about different ways in which the EMS system should run, but that's a different thread and quite frankly I hate getting into it on a forum.
We could go on and argue about different ways in which the EMS system should run, but that's a different thread and quite frankly I hate getting into it on a forum.
Shishkabob
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JP,
I agree, A&P is a necessity for EMS provider, but please, tell me how A&P, knowing how alpha and beta cells work, and the role of the pancreas will in anyway effect your decision about a D-stick?
It shouldn't.
As far as a basic is concerned with, hate to say it "most protocols";
Low BS and AMS? Most likely oral glucose.
Low BS but no AMS? Chances are no oral glucose.
High BS and AMS? No glucose.
I agree, A&P is a necessity for EMS provider, but please, tell me how A&P, knowing how alpha and beta cells work, and the role of the pancreas will in anyway effect your decision about a D-stick?
It shouldn't.
As far as a basic is concerned with, hate to say it "most protocols";
Low BS and AMS? Most likely oral glucose.
Low BS but no AMS? Chances are no oral glucose.
High BS and AMS? No glucose.
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If you are bagging a patient, they will need a ventilator so that patient DOES HAVE a serious problem. This can go either for a chronic or an acute patient.
I've already seen some serious errors with the use of the ATV due to improper education and training. If the AHA is pushing for it on the trucks, THEY should be helping EMS agencies beef up the education.
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Shishkabob
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Shishkabob
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Oh, ATV, nevermind I somehow read BGC and was confused when I saw pneumothorax...
^_^
^_^
Afflixion
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At both services I worked for yes they did. I believe it was necessary and as far as accuracy goes that was dependent on if our supply calibrated them properly or not. Bear in mind both services I worked for were 911. We did not have basic/ basic trucks. In Tucson we had medic/ basic or intermediate only, in El Paso (county) we had medic/basic or intermediate and more often than not intermediate/ basic trucks. El Paso county is VERY short staffed (or was) on medics the service had maybe about 4 on the schedule full time. The role of the basic is to assist the medic and the ability for a basic to perform glucose monitoring and SPO2 monitoring was maybe not so much necessary as much as convenience as it frees medics to perform other tasks providing better quality patient treatment.
How has this topic gone from asking about glucose monitoring to ventilators and EKGs? I'm sure the drastic jump occurred somewhere but I'm not going back to reading all that fun stuff.
LucidResq
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Texas or CO?
Afflixion
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El Paso, TX and Tucson, AZ sorry left out states forgot there are multiple other towns with same names.
Because again all the medical things are reduced to "skills" with very little education, training or knowledge. "I can poke a finger and put the blood into a machine just as good as anybody with a license". "I can turn a knob on a ventilator too". "I can put 10 little stickies on a chest and get a pretty picture".
Afflixion
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I do realize the importance of trying to get away from the whole "skills" aspect of EMS. My point was that If I'm busy doing something else why shouldn't I be allowed to have a basic get a glucose reading or SPO2 reading? It's not as though they are interpreting it.
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Shishkabob
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I have yet to see a single realistic argument as to why a basic shouldn't do a BGL test. Mainly just "Not enough A&P"
If you want to fight, fight the oral glucose. Fight the thing that can effect the outcome, not the tool that can help you decide if it's the right move or not.
If you want to fight, fight the oral glucose. Fight the thing that can effect the outcome, not the tool that can help you decide if it's the right move or not.
Afflixion
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I agree a basic should be allowed to obtain glucose readings(depending on the situation at hand). A lot of people seem to think of the basic as a provider when they are to assist the medic, at least in my neck of the proverbial EMS woods. As the medic is the provider the basic should not be doing the interpreting. Granted different areas are run differently with BLS only rigs and such but that brings up why you A ) need to standardize EMS or B ) have different protocols for different ares.
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