Bgl invasive

[emergancyjunkie]

Does anyone know why an emt-b in pa can give an epi-pen but can not check a bgl

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[Katy]

Does anyone know why an emt-b in pa can give an epi-pen but can not check a bgl

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You said it yourself, it is considered invasive and therefore EMT's aren't allowed to do it. Why that is, I don't know.

 

[WoodyPN]

So when the medic starts the IV, take the catheter from him/her and use the bit of blood on it to get the glucose.

 

[CAOX3]

There are still places thst don't allow EMTs to measure BGL?

 

[medicdan]

There are still places thst don't allow EMTs to measure BGL?

Yep! In fact there are places that don't allow EMTs to give epi pens.

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[emergancyjunkie]

There are still places thst don't allow EMTs to measure BGL?

Yea in pa we can't do bgl on a bls unit

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[Yarbo]

I'm thankful for being a Canadian EMT... lol can do a whole lot more skills at the basic level.

 

[CAOX3]

Yep! In fact there are places that don't allow EMTs to give epi pens.

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I've seen damage done with epi pens, but BGL seems ridiculous.

 

[18G]

I am on the fence with EMT's checking a BGL.

I admit it is an obviously simple skill I just don't see how it changes outcomes on the BLS level. If you get a decent history and pt. presents as diabetic, then treat as such. If patient is so altered and no family is around to give a history, treat as diabetic if your assessment steers you that way. Physical signs are present with a lot of hypoglycemia patients (diaphoresis, rapid pulse and breathing). I don't think the numerical value from a glucometer will effect treatment or prevent a diabetic from getting glucose as a BLS provider.

Would it be a nice thing to have? I think it would be nice but thinking clinically I don't see any improvement in treating patients. And if its not gonna change the patient care provided as an EMT than why do it? Maybe that is the level of thinking.

With that said, I do think it is extremely stupid that family calls EMS and the EMT's can't assess blood sugar and they have to ask the family to do it. When I was an EMT in PA I asked the family for the glucometer and did it myself. Technically not supposed to but oh well... slap my wrist.

I don't know if measuring BGL is going to be apart of the new EMT level or not. As an AEMT I know it will be in PA.

That is just my opinion on EMT's and glucometers in PA. Im not opposed to it and don't see a problem with it in and of itself Im just not seeing a real clinical benefit and that is where my mind is at. A Medic is more times than not gonna recheck it anyway when they arrive prior to treatment.

And more specific to your question comparing BGL assessment to Epi-Pens... an Epi-Pen has a significant clinical effect and is life saving. An Epi-Pen can mean life and death to a patient. The glucometer doesn't make a real difference in treatment rendered and can wait the few minutes for ALS to arrive.

 

[JPINFV]

I'd like to point out that the "invasive/non-invasive" discussion, as a matter of delineating between EMT level and paramedic level intervention is a red herring.

 

[ArcticKat]

I'd like to point out that the "invasive/non-invasive" discussion, as a matter of delineating between EMT level and paramedic level intervention is a red herring.

Agreed, "basic" EMS is just a lower form of advanced in most cases.

Our PCPs are able to insert King tubes, administer nitrous oxide, BGL, insert a Foley, 12 Leads, and CPAP. SubQ Epi, and several other meds.

 

[rmabrey]

My biggest issue is that it essentially forces my partner to take runs that I could take. Once we check a BGL its an ALS run even if the BGL is fine. And I hate that, especially on nights where hes down 8\\ or 9 runs and I havent had any.

 

[Anjel]

I am on the fence with EMT's checking a BGL.

I admit it is an obviously simple skill I just don't see how it changes outcomes on the BLS level. .

Whether it changes anything or not. It's nice to know exactly why your pt is unconscious or has an altered mental status.

We have oral glucose. And we can have a patient eat something. Why should they have to wait for ALS or to get to a hospital with something that is sometimes an easy fix.

Yes we could treat it without knowing the exact number. But I am more comfortable knowing exactly what I am dealing with. When it is something very easy to find out.

 

[bigdogems]

It is a result of a bigger problem in EMS. There is no standard from state to state. When I worked in WI an EMT-B could check blood sugar, give oral glucose, glucagon, draw up EPI, Albuterol, Atrovent,ASA, Pt assist nitro. Combi/king tube. Then there are other states where they aren't allowed to give any meds.

 

[CAOX3]

Whether it changes anything or not. It's nice to know exactly why your pt is unconscious or has an altered mental status.

We have oral glucose. And we can have a patient eat something. Why should they have to wait for ALS or to get to a hospital with something that is sometimes an easy fix.

Yes we could treat it without knowing the exact number. But I am more comfortable knowing exactly what I am dealing with. When it is something very easy to find out.

If there conscious I agree give them something to eat it will at least maintain their sugar.

As for unconscious diabetic its nice to know but it doesnt matter assist ventilations if need be and call for ALS, if your giving glucagon at the BLS level then yes a BGL is a must.

 

[Katy]

if your giving glucagon at the BLS level then yes a BGL is a must.

This right here is what I find very odd, you can give oral glucagon yet you cannot check the patient's BGL ?

 

[CAOX3]

This right here is what I find very odd, you can give oral glucagon yet you cannot check the patient's BGL ?

Glucagon is not given po, its given IM.

 

[18G]

Whether it changes anything or not. It's nice to know exactly why your pt is unconscious or has an altered mental status.

I agree it is "nice to know" but is it essential and does it change anything? It could help as a triage tool I will admit especially if ALS is not available. You could than walk into the ED with a BGL reading of 20mg/dl and get the patient treated a little faster.

 

[Katy]

Glucagon is not given po, its given IM.

Oops, I meant to write glucose.

 

[Anjel]

If there conscious I agree give them something to eat it will at least maintain their sugar.

As for unconscious diabetic its nice to know but it doesnt matter assist ventilations if need be and call for ALS, if your giving glucagon at the BLS level then yes a BGL is a must.

Our protocol states for any unconscious pt with the reason being hypoglycemia we are to give oral glucose buccally.

And before I start putting a sticky substance in an unconscious persons mouth...I want to know that it is actually their bgl that is the problem.