Blood Glucose Checks

[mar7967]

You are aware that hypoglycemic patients can present as positive on the Cincinnati Stroke Scale?

Yes, I was just saying the Cincinnati scale does not require a BG.

My protocols for diabetic emergencies state:
"Assess BG if available.
...
Treatment should not withheld from patients with a stroke-like presentation, as this is likely due to hypoglycemia."

Edit: Keep in mind we are talking about giving oral glucose only anyway. ALS would be able to do a BGL check even if BLS can't and go from there. BLS is not going to be giving a D50 drip or anything.

 

[JPINFV]

Except you said earlier...

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...

Emphasis added

So, what's the purpose of doing a stroke test if there is a high likelihood that a positive test is because the patient has hypoglycemia?

 

[mar7967]

Except you said earlier...



Emphasis added

So, what's the purpose of doing a stroke test if there is a high likelihood that a positive test is because the patient has hypoglycemia?

I guess you are right. I am not really sure, and like I have said, we can do BGL checks so I would be doing it anyway, and basing my decision to give oral glucose on the BGL.

 

[Too Old To Work]

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.

I see this way too often. Our EMTs are only supposed to use them to differentiate between CVA and Hypoglycemia when a patient has stroke like symptoms. Unfortunately, this has spread to just about every medical patient. Just the other night I arrived to find the BLS guys doing a BG on a patient with a complaint of dyspnea and chest heaviness. They hadn't put O2 on him yet, but they were convinced it was hypoglycemia. Of course it wasn't and the patient did everything but hang a sign that said "I have Angina" around his neck.

I'm constantly telling the BLS guys to put the glucometer away. The next step is bringing a mallet to work and smashing the things when they are used inappropriately. Our QA people don't seem to care about that.

And no Fox800, I don't work in Texas. I work about 2K miles away, but I guess the problems are the same.

If the only tool you have is a hammer, everything starts to look like a nail. If the only tool you have is a glucometer, everyone starts to look like a hypoglycemic.

 

[EmtTravis]

In IL we can also check bgl and also give glucose if needed.

 

[CAOX3]

If the only tool you have is a hammer, everything starts to look like a nail. If the only tool you have is a glucometer, everyone starts to look like a hypoglycemic.

This is priceless....unfortunatley its true.

 

[CAOX3]

This is priceless....unfortunatley its true.

Here let me fix this for myself unfortunately.

 

[JPINFV]

I believe the word you're looking for is "unfortunately

Darn it.. should have quoted you...

 

[medicRob]

This is priceless....unfortunatley its true.

Let me fix this for you.

This is priceless. Unfortunately, it's true.