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

[VentMedic]

We really grew out of fire departments and are still burdened by it. (That doesn't mean all firefighters are bad medics, but EMS needs to be its own profession if we are to advance)

But in many areas it is the FDs pushing for ALS. Granted they may have their own agendas but some areas would still be all volunteer BLS ambulances if the FDs has not taken the reins. Unfortunately it would be the EMTs on the BLS squad that would be arguing their care is more than adequate and may have never pushed the issue thus giving the FD an open door.

 

[Medic744]

We have it in the protocols for Basics here but do not run BLS trucks unless it is a rare volunteer truck. They are nice to have as a tool to point you in the right direction (if its working correctly) but we treat the patient not the equipment.

 

[Shishkabob]

2,000 hours for Ohio?

Texas only requires 624


So... Texas' medics are 1/3 of Ohio medics? :unsure:


LUCKILY, my class isn't the minimum.

 

[daedalus]

But in many areas it is the FDs pushing for ALS. Granted they may have their own agendas but some areas would still be all volunteer BLS ambulances if the FDs has not taken the reins. Unfortunately it would be the EMTs on the BLS squad that would be arguing their care is more than adequate and may have never pushed the issue thus giving the FD an open door.

You must feel secure with another license. I am jealous. When people write articles like that t worries me than I am investing 1500 plus hours and a few thousand bucks, plus all the other classes I took to get a Paramedic AS degree when my future colleagues might have 200 hours of training.

 

[Clibby]

That's the reason EMS grew out of fire departments. They have the funding and the influence. The problem is that its not always about patient care. Again I go back to the fact that you will not be able to significantly change the system until you attract better providers. Currently the good ones go to become RNs, respiratory therapists, etc because not only are they respected more, but they are paid significantly better. The other reason is that there is nowhere to go from paramedic: there is no upward mobility, nor is it easy to transfer knowledge to other professions to do so in another field such as nursing. If it was a degree program, the latter could be addressed. Basically, we need to attract better providers and hold on to them.

 

[LucidResq]

Texas only requires 624

Holy!

I'm going to be doing a minimum 650 hours of clinicals alone, never mind lecture.

 

[VentMedic]

That's the reason EMS grew out of fire departments.

Except for Freedom House Ambulance, the Paramedic program had its roots in the FD because of response time to the patients. The doctors thought they could teach a few advanced life saving skills to those who could get there quicker. Even in the 1960s the idea was for a Paramedic responder since there were already people with similar training to the EMT providing first-aid in many areas. It was not the intent for EMS to remain at a "BLS" level of care.

Currently the good ones go to become RNs, respiratory therapists, etc because not only are they respected more, but they are paid significantly better.

They are paid better because the education requirements are higher for entry level and that has also provided them a stance with the insurers for reimbursement.

How can you compare a 4 year college degree or even a 2 year degree with 634 hours of training?

 

[Shishkabob]

Holy!

I'm going to be doing a minimum 650 hours of clinicals alone, never mind lecture.

My school requires a minimum of ~400, but of course I'll be doing more.

 

[joshellis625]

we have a glucometer in each ambulances O2 bag (that's what we call it).

 

[Clibby]

You can't and not all programs are the same. The best way is to start by moving all training to educational institutions (colleges). Even a certificate program from a collage is going to be of a higher quality because the courses are taught to a standard. Currently there is no standard other that being able to pass a test.

BTW how did we digress so far. As to the topic itself my position still stands: As long as basics are giving oral glucose, which they should be allowed to, there is nothing wrong with giving them the tool to determine whether the treatment they are about to give is necessary. BGL testing should be a BLS skill.

 

[jtb_E10]

thats a negative in Indiana....only EMT-Advanced and up can here...

 

[VentMedic]

BGL testing should be a BLS skill.

How I hate the term BLS or even ALS. One should not look at patient care in these terms. Patients deserve better than to be labeled by these EMS terms that only serve to provide job security for the lowest common denominators.

thats a negative in Indiana....only EMT-Advanced and up can here...

Or to add another cert to the 50+ that already exist.

 

[CAOX3]

How I hate the term BLS or even ALS. One should not look at patient care in these terms. Patients deserve better than to be labeled by these EMS terms that only serve to provide job security for the lowest common denominators.

Or to add another cert to the 50+ that already exist.

I agree it should be referred to as patient care, as far as job security there is about two-hundred people below me.

 

[JonTullos]

In Mississippi a Basic can't check BGL because the state considers it an invasive procedure. My instructors think this is stupid, most medics think it's stupid and I think it's stupid. I've known how to check BGL since I was a kid (I'm hypoglycemic). It's not like it's complicated so I don't get it. Oh well.

 

[rmellish]

In Mississippi a Basic can't check BGL because the state considers it an invasive procedure. My instructors think this is stupid, most medics think it's stupid and I think it's stupid. I've known how to check BGL since I was a kid (I'm hypoglycemic). It's not like it's complicated so I don't get it. Oh well.

Playing devil's advocate here, but how would a BGL reading change your interventions as a basic?

thats a negative in Indiana....only EMT-Advanced and up can here...

But advanced emts still can't administer anything but oral glucose, so it really doesn't change a whole lot in your treatment of an unresponsive, or severely altered patient. You'd still be requesting a medic and/or moving towards definitive care.

The capability isn't bad thing to have, especially if you already have a flash chamber full of blood to test on. The ER will generally check it again as part of their assessment though.

Or to add another cert to the 50+ that already exist.

Yeah, scary thing is that it's classified as ALS up here.

 

[Katie Elaine]

can CT basics give epi pens then or sub-Q epi or is that too considered invasive?

We can give epi pens, nothing sub-Q though.


Doing a BGL check isn't going to change my treatement by a whole hell of a lot, but it will give an indication on what I'm dealing with, and whether or not to administer Oral Glucose. Granted, if the pt is so far gone that they cant swallow, then it's not going to matter. I'm always going to contact a medic if its a diabetic-related emergency and the call calls for a medic, but getting a BGL reading sometimes helps narrow down what the issue may be and how to go about the issue. But I also do not go stricktly off of the 80-120 rule. If my pt has a 75 blood sugar reading, I'm not going to load them up on oral glucose.

 

[firemoose0827]

Playing devil's advocate here, but how would a BGL reading change your interventions as a basic?

Just makes it quicker for the arriving medic, he/she already has a reading now they can do their job faster, instead of wasting another 5 minutes to grab a reading.

But advanced emts still can't administer anything but oral glucose, so it really doesn't change a whole lot in your treatment of an unresponsive, or severely altered patient. You'd still be requesting a medic and/or moving towards definitive care.

What is the protocol for your state for ALS providers? Advanced EMT's in my state can push Dextrose IV, so it does change the treatment of the patient. Just to remind you to think outside the box a little, and think about different states having different protocols. Stay safe everyone, and hello by the way! Im brand new here and looking forward to chatting with you all.

 

[rmellish]

In terms of scope of practice, I was referring to advanced EMTs in my state.

And it takes less than a minute to get a BGL reading. Trust me, I'm all for expanding the scope, but with all other factors remaining the same, adding BGL for basics wouldn't change a whole lot in terms of patient care.

 

[firemoose0827]

In terms of scope of practice, I was referring to advanced EMTs in my state.

And it takes less than a minute to get a BGL reading. Trust me, I'm all for expanding the scope, but with all other factors remaining the same, adding BGL for basics wouldn't change a whole lot in terms of patient care.

Well said. We all have our opinions, and I am not trying to change yours in any way. Just simply stating that the introduction of BGL wont hurt anything either, so why not at least let them obtain a reading and use it as another diagnostic tool to better attempt to diagnose what the underlying medical problem is. The more info we obtain for the ER the better, after all, we are an extension of the ER and they "Guide" us via med control, so why not try to get as much as we can in the field, if not for immediate use than for an ongoing assessment of the patients condition. Good points, thanks for the chat.

 

[JPINFV]

What is the protocol for your state for ALS providers? Advanced EMT's in my state can push Dextrose IV, so it does change the treatment of the patient. Just to remind you to think outside the box a little, and think about different states having different protocols. Stay safe everyone, and hello by the way! Im brand new here and looking forward to chatting with you all.

Wait. You have providers pushing dextrose who aren't allowed to take a BGL?