Blood Glucose Checks

medicRob said:
In TN, our EMT-IVs can check blood glucose levels, administer oral glucose and D5w, and D50. There is a push right now in our state to move from the EMT-IV level to what is known as "EMT-Advanced" which adds the ability to initiate 12 leads (but not read them, yes I know how redundant this sounds), and to administer narcan. They are doing GAP analysis right now with regard to the DOT National Standard vs EMT-IV.
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I think it's because TN made their own level of EMT, then only requires a basic certification to become licensed. Which is odd, because I believe we can do everything a EMT-I/85 can do - minus the optional intubation some states do. Because we have IV therapy and the combitube out here. Seems other basics on here can't do most of these things?

That's why I wince when classmates struggle with the basic test. If they knocked us up to the I/85 I think less would be licensed.
 
EMTs in Texas can use glucometers. Our first responders LOVE to do it, even when it's painfully obvious that there's no need. You got rear-ended and your ankle hurts, and you have no history/meds/allergies? Better check a blood glucose!

For billing, blood glucose measurement automatically qualifies as an ALS transport. Congratulations! Now their transport bill is $1000+ instead of $600.

I always facepalm when this happens, I often tell them to stop when they're getting ready to do one.
 
Fox800 said:
For billing, blood glucose measurement automatically qualifies as an ALS transport. Congratulations! Now their transport bill is $1000+ instead of $600.
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Yeah, my company is like that too. If you're an I/B rig, before letting the Basic handle it, an "ALS" or "ILS Assessment" must be done, which always includes a BGL, so they can bill for it.
 
Negative for Indiana as well.
 
In NC, use of glucometers and oral glucose is a pure basic skill, though all of the services in my area run all ALS units.
 
For teh states that aren't allowed to do a CBG, do you carry oral glucose and is that within your scope?
 
In MA we do carry oral glucose. It's in the protocol for unknown AMS in a conscious pt.
 
Its a requirment here in Ohio- I have to test myself often so I'm relatively adept at it
 
Fox800 said:
EMTs in Texas can use glucometers. Our first responders LOVE to do it, even when it's painfully obvious that there's no need. You got rear-ended and your ankle hurts, and you have no history/meds/allergies? Better check a blood glucose!

For billing, blood glucose measurement automatically qualifies as an ALS transport. Congratulations! Now their transport bill is $1000+ instead of $600.

I always facepalm when this happens, I often tell them to stop when they're getting ready to do one.
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Wow that's idiotic. There is no reason to check it in that instance.
 
New York leaves it up to the individual regions to determine I believe. My region allows EMT-B's to check BGL if their agency is approved to do so, and if they have gone through training on how to do it. Even if you can't check BGL, you are still allowed to give oral glucose in a diabetic emergency (better to give glucose to a hypoglycemic pt than to withhold from a hypoglycemic pt)
 
Wisconsin EMT-Basics check Blood Glucose and can administer Oral Glucose and Glucagon IM.
 
here in MA there are many fire dept that check the BS level.. and when im on the intercept truck and the FD doesnt get a BS for an unresponsive i get quite peeved
 
What the deuce, how can they allow you to dish out glucose but not do a BGL? Gah!

Our Ambulance Technicians can check a BGL as well as give IM Glucagon and PO Glucose (10% Glucose drawn out a 500ml bag we'd normally give IV)

So legit question, how do those of you can give glucose but not do a BGL differentiate between hypoglycaemia and say, a stroke or an altered patient where glucose will be harmful?
 
MrBrown said:
What the deuce, how can they allow you to dish out glucose but not do a BGL? Gah!

Our Ambulance Technicians can check a BGL as well as give IM Glucagon and PO Glucose (10% Glucose drawn out a 500ml bag we'd normally give IV)

So legit question, how do those of you can give glucose but not do a BGL differentiate between hypoglycaemia and say, a stroke or an altered patient where glucose will be harmful?
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If the pt has a history of diabetes, and it presents as a diabetic emergency, our protocols say to give glucose. You can do a stroke test to see if they are possibly having a stroke...but the theory I guess is that it is less dangerous to give glucose to a hyperglycemic person than to withhold from a hypo.
 
mar7967 said:
You can do a stroke test to see if they are possibly having a stroke...
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There's a reason why Los Angeles Prehospital Stroke Scale requires a blood glucose level.
 
JPINFV said:
There's a reason why Los Angeles Prehospital Stroke Scale requires a blood glucose level.
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I was not aware of the LA stroke scale. I was only taught the Cincinnati Stroke Scale.

My agency is able to check BGL, but not all in my area can. I don't really know what they do, but that is what our protocols state.
 
You are aware that hypoglycemic patients can present as positive on the Cincinnati Stroke Scale?
 
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