Diabetic question

[Max]

Greeting Everyone,
I have a bit of a predicament.
For the Summer I took a job as an EMT/Health Director in a camp. There is 1 camper who is a type 1 diabetic and she takes daily insulin injection. There is one division head (no official medical training whatsoever) who was trained and authorized to assist with the injection by the parents of this child. Now that staff member is about to leave and no one will be able to do the injection. Of course we all know that an EMT basic is not certified to administer insulin but will I violate my scope of practice if I get written/signed consent from the parents to assist with the insulin administration. (This child knows what to do, she can measure her blood sugar, measure the proper dose for the insulin, the only thing she is incompetent in is the actual injection which is administered through an auto injector).
Thanks a lot

 

[STXmedic]

Talk to your medical director and explain the situation.

 

[Carlos Danger]

Not knowing the regs in your state, I would imagine that your medical director can authorize you to administer an insulin auto-injector.

Honestly, probably a better way to go is for the child to self-administer, with you watching only as an extra set of eyes to help avoid an error. If she can measure her own glucose and accurately measure her insulin dose, then she should certainly be able to administer her own injection. In fact she probably needs minimal help if any.

Important question: can you use a glucometer as an EMT in your state? As you may or may not know, missing a dose (or underdosing) of insulin will not in any way result in any type of medical emergency.....it probably just means that her next dose or two will need to be higher. If it does get a bit out of control, a call to her doctor should help you/her sort it out.

What you really need to worry about is hypoglycemia. This is pretty uncommon in otherwise healthy, active diabetics who have their diet and insulin regimen dialed in, but it is certainly possible. That's why you need to have on hand and be able to use a glucometer, glucose gel, and even a glucagon auto-injector, if possible.

None of this should be a big deal. Start by talking to your medical director, and he or she will probably need to talk to this kids parents.

 

[Max]

Let me explain a little more in detail about what goes on
This girl takes insulin on a needs basis. She is very good at keeping track of her blood glucose levels. She knows to take a blood test before eating, exercise, etc. When she realizes that her numbers are getting high, she will go to the counselor who has the training and consent by the parent to assist her. This counselor will text the girls glucose levels to the parents and the parent will text back EXACTLY how much insulin to give and other procedure if necessary (example: eat a cracker). This Girl will then set up the everything and the counselor has to do 2 things: set the dial to the proper amount and administer the insulin. I honestly don't know why the girl can't give the injection herself but they tell me she requires assistance.
To my understanding (correct me if I am wrong), there are 2 parties responsible when administering medication; one is the medical authority who advises the administration and there is the one who actually administers it. Being that this procedure requires me to consult with the parent who has authorization to give the insulin AND knows exactly what to do, am I able to obtain consent from the parent to be the one to administer the insulin even though my BLS protocols will not allow me to?

Thanks for the input Remi, just to address your response
I am a NJ EMT and this camp job is in NJ. I am not allowed to use a glucometer in NJ. I definitely understand that missing a dose is not the end of the world but as I already mentioned the parent knows exactly how much to give despite the number so that is not a big concern. (sorry if that was unclear)
In terms of Hypoglycemia, I have glucose on hand but as you mentioned it would definitely help to be able to use glucometer.

 

[Smitty213]

I will not profess knowledge to NJ law, however, generally NY and NJ are similar... I worked at a camp in NY, and while operating as the health officer of that camp I was not operating (technically) as an EMS provider, therefore my regional ALS protocols didn't have any bearing on my position at the camp. The doctor that oversaw the camp had the capability to write his own protocols for me that encompassed prescription medication administration (insulin, daily meds, etc.) and other procedures not found in the ALS or BLS protocols of the state. I would say your best bet would be to talk to the doctor that oversees the camp and ask what he would like you to do.