Glucometers for BLS

[ffemt8978]

Originally posted by KEVD18@Apr 15 2005, 07:23 PM
see i counter that with the question: "how invasive is a bg stick" i mean we're not talking running a central line here, its a prick on the finger.

Have you read the 2nd Draft of the EMS Scope of Practice yet?

They consider it to be invasive, therefore, it will not be a Basic skill. They also take away combitubes and I believe Epi-Pens away from the basic level.

I'm not saying I agree with this, 'cuz I don't. As you pointed out, a 6y/o can do a BGM stick. It makes no sense not to let a basic do them.

 

[KEVD18]

yeah... i get that its "classafied" as an invasive procedure. but in reality, not so much

you said "they" were taking combitubes and epipens away from basics. who's they?? a state ems board? the nremt?

 

[ffemt8978]

They as in those that wrote the Scope of Practice.

 

[devist8me]

Our service just last year started allowing EMT's to use the glucometer. Before that, I think our medical director was thinking along the lines of "its invasive so no" blah blah blah. The education dept did big research on it and it was finally decided to allow it. All the EMT's were trained and can now test.

Even though there are a few BLS trucks here, most have atleast one medic on board. Its nice to have the EMT do the D-stick while I get the line (can't use the blood from the catheter due to the type glucometers we use). Also, we don't go by the pt readings, even if they just checked it prior to us arriving. Thinking here is we don't know how accurate their machine is and we test ours at the beginning of every shift. So, every diabetic gets another stick.

 

[KEVD18]

"scope of practice" for where? it may be that i'm just unfamiliar with that term. are you speaking of just your service/area/state. or is this a nremt thing? or a dot thing? thanks in advance for clarifying

 

[ffemt8978]

It's the new proposed scope of practice authored/sponsored by the NHTSA (National Highway Traffic Safety Administration). My guess is that the NREMT will follow the final Scope of Practice document and modify their standards accordingly.

This in not saying that every state will follow this scope, just like now, where not every state follows the NREMT scope.

It is a proposal to change the national standards of EMS care, with the ironic title of "Freedom Within Limits". It seems to me that there are more limits than freedoms, and the care provided at the EMT-B level is going to suffer.


Oh yeah, this is my
1000th
post. Did I win something?

 

[KEVD18]

gotcha. thanks for the info. will be looking for the change

 

[CodeSurfer]

Originally posted by ffemt8978@Apr 17 2005, 05:29 PM
It's the new proposed scope of practice authored/sponsored by the NHTSA (National Highway Traffic Safety Administration). My guess is that the NREMT will follow the final Scope of Practice document and modify their standards accordingly.

This in not saying that every state will follow this scope, just like now, where not every state follows the NREMT scope.

It is a proposal to change the national standards of EMS care, with the ironic title of "Freedom Within Limits". It seems to me that there are more limits than freedoms, and the care provided at the EMT-B level is going to suffer.


Oh yeah, this is my
1000th
post. Did I win something?

Yeah, San Diego protocol allows for combitubes, but only one private company allows BLS to use them. Protocol also includes activated charcoal for BLS, but none of the ambulances (BLS) here include it. Thats fine about the charcoal though... I've never been fond of black vomit anywhoo.

 

[rescuecpt]

The guy I worked with last night refuses to use combi tubes because one of his pts had a severe allergic reaction to the latex in the cuffs.

 

[CodeSurfer]

Originally posted by rescuecpt@Apr 17 2005, 10:18 PM
The guy I worked with last night refuses to use combi tubes because one of his pts had a severe allergic reaction to the latex in the cuffs.

Everyone I've ever asked said they've never used it. Mostly because San Diego has so many medics that people just end up being intubated. One proctor in my class did say he heard of one being used when the medics couldnt see the chords of a self inflicted GSW to the face... (he didnt make it even with the combitube... suprise)

 

[DFDEMS]

I was under the impression that within Michigan it was approved but left up to the discretion of the regional medical director? Either way, I think they should be allowed to.

 

[MMiz]

Originally posted by DFDEMS@Apr 18 2005, 12:10 AM
I was under the impression that within Michigan it was approved but left up to the discretion of the regional medical director? Either way, I think they should be allowed to.

That's correct, it is up to the individual department / company.