BLS and Combitube

[jjesusfreak01]

What's that? An expensive piece of plastic pushed on services by a manufacturer may not be all it cracked up to be? Say it ain't so!! 

We use them religiously around here, but we don't turn on the pacing light, and per instructions they come off the second the pt gets pulses back. I'm not going to worry about the science behind them. I'm sure if it starts to look like they aren't helpful, our medical director will chuck them quicker than you can blink.

 

[Handsome Robb]

Arrest? Not checking the BGL obv

Why not? Hypo/hyperglycemia is one of the H's and T's of ACLS and an easily reversible cause of an arrest...

We use King's not combi's, both do their job though.

 

[IAems]

Can't check BGL (in my county). Our BLS rigs don't carry the meter because it's not in our scope <_<

Sorry to hijack this thread again, but glucose readings are out of our scope too, so I carry my personal glucometer around; that way, in the event a certified paramedic or even lay person should want to check it, there will be one readily available. . . I mean the repercussions of a trained medical provider haphazardly monitoring a BGL could be disastrous. Here's a line I heard once, "Not that I checked because it would be beyond my scope, but somebody reported the BGL @ around 652 mg/dL three minutes ago."

 

[SnaKiZe]

Sorry to hijack this thread again, but glucose readings are out of our scope too, so I carry my personal glucometer around; that way, in the event a certified paramedic or even lay person should want to check it, there will be one readily available. . . I mean the repercussions of a trained medical provider haphazardly monitoring a BGL could be disastrous. Here's a line I heard once, "Not that I checked because it would be beyond my scope, but somebody reported the BGL @ around 652 mg/dL three minutes ago."

Sorry to hijack, but i really don't understand how obtaining BGL are out of scope for EMT-Bs. Hell, even the average schmuck can check BGL.

 

[TransportJockey]

He's in CA. That's the reason alone that he can't do it. I know in every state I've worked in, EMT-Bs can check CBG

 

[rwik123]

Why not? Hypo/hyperglycemia is one of the H's and T's of ACLS and an easily reversible cause of an arrest...

We use King's not combi's, both do their job though.

Little late to jump on me for that. It's been cleared up earlier in the thread. ACLS? Sorry I'm a basic.

 

[Handsome Robb]

Doesn't mean you couldn't gather information for an incoming ALS crew if its within your protocols.

I know lots of basics that have ACLS provider cards. No such thing as too much education, it's not just limited to paramedics.

 

[rwik123]

Doesn't mean you couldn't gather information for an incoming ALS crew if its within your protocols.

I know lots of basics that have ACLS provider cards. No such thing as too much education, it's not just limited to paramedics.

Yeah I was wrong when I said that in the first place. I realize that I could in the future, handoff something to a first responder and check BGL.

I just meant that I have no knowledge of the specifics of ACLS in regards to Hyper/hypoglycemia in an arrest situation, but I'm open to learn.

 

[Deltachange]

And I will thread hijack, if you get your ACLS as a basic, does your scope change for doing so? I am looking for a class, because I want to learn, but will it be immediately applicable if I do get the card?

 

[rwik123]

And I will thread hijack, if you get your ACLS as a basic, does your scope change for doing so? I am looking for a class, because I want to learn, but will it be immediately applicable if I do get the card?

Your scope won't change. As I've heard, the ACLS for basics consists of setting up IV bags and place electrodes. I'm not sure if a basic can sit in a medic level ACLS course but If they could, I think it would be more knowledge based, not being able to do any of the interventions (100% sure on the scope not changing).

 

[rwik123]

And correct me if I'm know, ACLS for medics doesn't add any scope...just adds information and techniques with already learned interventions from your medic scope.

 

[Deltachange]

set up IV bags of what? With my IV I can already hang LR and NS, and the basic EKG course lets me set up electrodes for twelve leads. I would love the knowledge base anyways, because Cardiology and the meds fascinate me. Thanks!

 

[Shishkabob]

And I will thread hijack, if you get your ACLS as a basic, does your scope change for doing so?

No, the card does not dictate your scope, your employer / state do. All the card says is you passed a test.




I would recommend ACLS for EMTs. You won't understand most of what is said / discussed if you're just fresh out of EMT school, but getting the basic thought process of what an ALS crew does in a cardiac arrest is always beneficial. Only other way to get that information is to be on a bunch of cardiac arrests.


Join my truck... we've had 4 cardiac arrests in the past 6 shifts...

 

[usafmedic45]

I know in every state I've worked in, EMT-Bs can check CBG

We never could as BLS providers. Granted, we never let that stop us from having a "bystander" do it if the patient was a known diabetic and had a glucometer present.

 

[Shishkabob]

We never could as BLS providers. Granted, we never let that stop us from having a "bystander" do it if the patient was a known diabetic and had a glucometer present.

In Texas, it's viewed as a gray area as it's technically "invasive", though I don't know of a single service that doesn't allow it, and DSHS really can't dictate one way or the other.

 

[TransportJockey]

We never could as BLS providers. Granted, we never let that stop us from having a "bystander" do it if the patient was a known diabetic and had a glucometer present.

Heh, well so far that's only three states Although now that I think about it, with the retarded EMT-B IV level in CO a true EMT-B can't check CBG. Just the IV add-ons can.

 

[usafmedic45]

Ah....like I said, we never let it stop us if we really thought it necessary. Given our medical director's military background he was very much (at least for those of us in supervisory roles) of the "better to beg forgiveness than to ask permission" mindset on things that could be life or death. Granted, having to beg forgiveness from that man was an experience I didn't relish so I was very judicious in the situations I put myself into needing to do that. I'd rather teabag a rabid wolverine that is high on PCP in a locked telephone booth.

 

[usalsfyre]

I'd rather teabag a rabid wolverine that is high on PCP in a locked telephone booth.

That's one hell of a visual.

 

[Tigger]

Heh, well so far that's only three states Although now that I think about it, with the retarded EMT-B IV level in CO a true EMT-B can't check CBG. Just the IV add-ons can.

In the current CO Rule 500 (Colorado Board of Medical Examiners Rules Defining the Duties and Responsibilities of Emergency Medical Services Medical Directors and The Authorized Medical Acts of Emergency Medical Technicians), Blood Glucose Monitoring is an approved skill for all levels of providers. Also, no EKG class is technically needed to place electrodes and send data in Colorado, I know this was taught in my basic class. I think the combitube is similar in that its placement by basics is allowed, though at least in my area, your agency must provide you with additional training and approval.

 

[TransportJockey]

In the current CO Rule 500 (Colorado Board of Medical Examiners Rules Defining the Duties and Responsibilities of Emergency Medical Services Medical Directors and The Authorized Medical Acts of Emergency Medical Technicians), Blood Glucose Monitoring is an approved skill for all levels of providers. Also, no EKG class is technically needed to place electrodes and send data in Colorado, I know this was taught in my basic class. I think the combitube is similar in that its placement by basics is allowed, though at least in my area, your agency must provide you with additional training and approval.

Heh makes sense. Since I only worked briefly in co I couldn't remember. Besides I was an I/85 that git stuck as a B IV... Never did classes in co.