Does your BLS protocal incl. glucose monitor finger-stick?

[Sasha]

Why wouldnt a medical director allow an EMT use of a BGL monitor?

i suspect it's the same reason some don't allow for pulse ox's. Lack of education.

 

[Shishkabob]

i suspect it's the same reason some don't allow for pulse ox's. Lack of education.

On behalf of the doc, or the basic?

Honestly, no education is required for the use of BGMs or PulseOx. What is required is some critical thinking, which admittedly some people lack, but still.


They have the interventions, but not the tools. That's not safe.

 

[CAOX3]

i suspect it's the same reason some don't allow for pulse ox's. Lack of education.

I know the amount of education needed to operate a diagnostic tool is vast.

Im guessing its financial.

 

[JPINFV]

Operation is easy. Interpetation is hard.

 

[Freddy_NYC]

thank you everyone for your terrific replys!

 

[scottmcleod]

Operation is easy. Interpetation is hard.

QFT (quoted for truth), But, recording vitals can help build a better history for ALS or the hospital.

Same reason an ECG/EKG strip on first arrival can be incredibly helpful to the hospital...

 

[JPINFV]

That may be true to an extent, but you can't expect providers to get a number and just write it down and not use it. Same reason why basics in vast majority of the country can't obtain a 3/5/12 lead for the hospital later.

 

[Shishkabob]

As I said in the post above---

Having the intervention without having the tool is dangerous.

 

[JPINFV]

I would hardly call oral glucose an intervention worth crying about. That's like saying we shouldn't splint an arm unless we have an x-ray machine.

 

[Shishkabob]

Because giving someone glucose that's hyperglycemic and causing a myriad of bad things to happen is so relatable to splinting an extremity.


Splints are preventative in nature. Glucose is to fix a problem.

 

[JPINFV]

You aren't going to cause any drastic problems by giving someone who is hyperglycemic oral glucose and if you have the ability to administer glucagon or IV dextrose, then you should have the education to use a BGL.

 

[Shishkabob]

You should have the education to work the glucometer regardless.

 

[JPINFV]

Are you suggesting that the current 110 hour EMT-B curriculum (soon to be replaced, though), is enough?

 

[Shishkabob]

Nope.

I'm saying it's a tool and should be treated as such. Poking someone with a stylet and using a glucometer won't kill anyone (unless your names WillBeFlight).



Now, USING that info is different. That's where common sense comes in.



/me waits for the EKG comparison.

 

[JPINFV]

...and my argument is that there is no real reason to use a tool, regardless of how easy it may be, if you, or someone in the immediate area (e.g. hospital technicians), can not use the information. Now using the information requires not just common sense, but also education.

 

[Shishkabob]

But obviously basics CAN use the information gathered from a glucometer, can they not?


This is why the glucometer cannot be compared to the EKG.

 

[JPINFV]

If by obviously, you mean read number, apply to set range, ignore individual variance, then yes. Of course, in that case, why not give basics pulse ox, capnography (hey, just use the number), and I-stats? After all, if it's just read number, compare to memorized range, have fun, then it shouldn't be an issue.

 

[Shishkabob]

Now you're just putting words in my mouth.

Like I said-- common sense. If BGL reads 50, but they are AOx4, then use (generic)your brain.








PS--- we do have pulse ox down here. Like I said, it's a tool, not the final decision, and the doctors realize that.

 

[Clibby]

Why couldn't you use it? MA is actually implementing BGL monitoring for basics via a state waiver.

You have a patient that has an AMS and is a known diabetic. The patient is still alert and able to swallow. Protocol says give him oral glucose. But what if its high blood sugar? Yeah the glucose will most likely not harm him. But what if its a hemorrhagic stroke, then you know it will. People react differently to strokes in different parts of the brain. On a more practical note, if your called to the patient who hasn't eaten, went running, AMS, no history of diabetes, but is able to swallow. According to protocol we cannot give this pt glucose, but with a glucometer reading that says 45 you bet we can. I know we are playing the what if game, but I don't see why we don't have it in the first place. (all patients I have encountered)

I just think this particular issue is one where talking about the education issue is ridiculous. If a doc can talk it through with a patient in 10 min, how come its such an issue here. I know the system needs to be revamped heavily, but this has little to do with BGL monitoring. We aren't talking about IV glucose, we are talking about oral glucose. As it is, protocol tells us to give it whether they need it or not if a diabetic has AMS. This isn't something that requires a whole lot of understanding. For the extra 20 minutes (max) it takes to understand the whole concept, it could be a tool for basics to help ease the burden of ALS in most areas.

 

[JPINFV]

I just think this particular issue is one where talking about the education issue is ridiculous. If a doc can talk it through with a patient in 10 min, how come its such an issue here. I know the system needs to be revamped heavily, but this has little to do with BGL monitoring. We aren't talking about IV glucose, we are talking about oral glucose. As it is, protocol tells us to give it whether they need it or not if a diabetic has AMS. This isn't something that requires a whole lot of understanding. For the extra 20 minutes (max) it takes to understand the whole concept, it could be a tool for basics to help ease the burden of ALS in most areas.

Oh, this argument? You know, some patients are on ventilators at home. Heck, it's just a bunch of knobs and the basics can be taught to families for home care. Why not let EMT-Basics use ventilators?