Glucose sticks

[skyemt]

in most areas i know of, emt-b's can not due glucose sticks to determine bgl's... seems to me to be something at would be useful...
would like thoughts from advanced providers on this...
thanks...

 

[emt/ff71185]

We are allowed to do sticks in my system and we do so all of the time. I wouldn't want to operate without the ability because it can help so much in figuring out, or at least ruling out a certain problem.

 

[skyemt]

that is my thought... however, in my state, it is an ALS skill only...
i'm sure there is another side to it, and i was looking for insights into what it is...

 

[medic001918]

They recently introduced blood glucose monitoring for BLS providers in my area, but many services have not completed the roll out for the protocol yet. I think that part of the reason why many areas do not give blood glucose monitoring to their basic providers is that it's not going to change the course of your treatment at all really. If someone's concious and altered, you can try to give oral glucose and see if the condition resolves. I know the argument that's glucose can increase intracranical pressure if the problem turns out to be a stroke, but the amount of glucose we would give would have a minimal effect if any at all. If a patient is unresponsive, you should have ALS coming anyway (if available). Knowing a blood glucose level doesn't really effect any of your treatment modalities.

The other argument that I've heard is that most BLS providers aren't trained in using sharps, and are not trained in invasive procedures. While it's a minimally invasive skill, it does involve a needle puncturing the skin. People at home with diabetes are given instruction (or should be) by their healthcare provider as to when and how to use their equipment. So they've been "in serviced," however minimally it may have been.

As a paramedic I would tend to recheck someone's blood glucose using my glucometer even if a BLS provider had one for me when I got there. The reason for that is to ensure that their reading was accurate (I know when my glucometer was calibrated), and also so that I can have before and after readings from the same machine. That part could simply be me being how I am...but it's how I do things. If a basic wants to check a blood glucose level, go ahead. It doesn't effect treatment though within the BLS scope for the areas I work.

Shane
NREMT-P

 

[rmellish]

I think that part of the reason why many areas do not give blood glucose monitoring to their basic providers is that it's not going to change the course of your treatment at all really. If someone's concious and altered, you can try to give oral glucose and see if the condition resolves.... If a basic wants to check a blood glucose level, go ahead. It doesn't effect treatment though within the BLS scope for the areas I work.

Shane
NREMT-P

Thats pretty much how it was explained to me in EMT class, with the added caveat that diabetics can run all kinds of blood glucose levels so that a high for one person could be a low for another. Because of this, I'm sure they don't want glucose withheld, mostly due to its low risk at BLS doses.

 

[emt/ff71185]

There is one case in which a reading is very helpful at the B level. We get many drunks in my district called in by cops and being how the symptoms are so similar it is very helpful just to stick them and find out instead of trying to get accurate info out of the possible ETOH patient.

 

[disassociative]

Here, our EMT-IV(Emt-B with extra skills and training in TN) are taught to apply glucometry to ANY patient presenting with Altered Mental Status; regardless of whether you think they are drunk or not.

It is quick, easy, and provides valid information.

 

[Alexakat]

EMT-B's do 'em here in Southeastern Virginia. I do a glucose check on pretty much on every patient...

 

[BossyCow]

We must have a glucose reading on every patient we bring into our ER. Often we don't even have to stick the Pt. If an IV is started, the flash from the IV cath usually contains enough blood to work the glucometer.

 

[DisasterMedTech]

We do them here in Region 1 of Illinois and usually, depending on the CC of the patient, its just a regular tack on to the vitals. One more bit of information for the docs and nurses. Plus in my EMT class we spent ALOT of time on DKA and HHNS, so the thinking of some of the medical directors is that since we got the other vitals, which now often also include a temp reading, we can give the wad of collected information to the medic and he/she can determine the course of pre-hospital Tx on which they wish to proceed. I like the system we have here and so do most of EMTs and Medics I have talked to.

 

[Mercy4Angels]

come on there are ways to cheat. i had the patients daughter do it once. just have a family member do it and your safe.