Obtaining BGL

[subliminal1284]

In Wisconsin checking BGL is part of our normal assessment we can also administer glucagon via IM injection as an EMT B

 

[Vivian]

I am an EMT-B in Maryland, in the western half of the state I can get BGLs, in the eastern half I cannot. I don't know of any other policies that change depending on where you are in the state, but at least in Western Maryland I can do it and do it often.

 

[EMSSam]

By obtaining a BGL, you simply mean to lance the finger and draw blood onto the strip in a BGL device, right?

I only ask this because that seems far to simple a skill not to be allowed to be done by EMTs. I'm a student and on my first on-road shift with the ambulance as part of my university course I was already doing BGLs.

 

[DesertMedic66]

Yeah that's what they mean. The general rule it seems is "don't give EMTs any kind of object that can poke the patient" :glare:

 

[Anthony7994]

I had no idea that obtaining a BGL was NOT allowed to be done by all basics? It's pretty simple and, as many stated, not invasive at all. Just another essential assessment tool.

 

[DesertMedic66]

I had no idea that obtaining a BGL was NOT allowed to be done by all basics? It's pretty simple and, as many stated, not invasive at all. Just another essential assessment tool.

It is allowed to be done by basics in different areas. My protocols changed this month now allowing basics to get BGLs.

 

[94H]

Yeah that's what they mean. The general rule it seems is "don't give EMTs any kind of object that can poke the patient" :glare:

Except Epi-Pens!

 

[DesertMedic66]

Except Epi-Pens!

But EMTs (at least in my area) we can only assist the patient.

 

[jjesusfreak01]

My patient on a BLS IFT transport went hypoglycemic enroute the other day. I noticed the change in mental status, checked BGL (was 35), and had my paramedic partner pull the truck over so we could fix it. We ended up getting permission from the SNF to continue transport of our now stable patient, and all was well.

As an IFT agency, we transport maybe 20% diabetic patients, and it would be irresponsible for us NOT to have capability to check BGL.

 

[preggoeggo]

In NC it's a basic skill. Although in my county, you have to pass expanded scope boards in order to obtain BGL. So...the state says I can, the county says I can't. (Less further testing) I guess they think we're going to poke our pt's in the eye? I can't figure it out.

 

[pghboy2011]

Is obtaining a PT's Blood Glucose Level as an EMT-B in ANYONE'S scope of practice?? ? ? ? ? ? ?:blink:

Yeah, that's one of those silly rules that seems to be pretty standard...I mean...if you cause someone harm by checking a BGL, you've royally screwed up, and don't deserve your cert...:rofl:

 

[Christopher]

In NC it's a basic skill. Although in my county, you have to pass expanded scope boards in order to obtain BGL. So...the state says I can, the county says I can't. (Less further testing) I guess they think we're going to poke our pt's in the eye? I can't figure it out.

Actually, in NC it is a Medical Responder skill (Procedure 25 - Blood Glucose Analysis; MR thru EMT-P)...so are EpiPens.

 

[pghboy2011]

Actually, in NC it is a Medical Responder skill (Procedure 25 - Blood Glucose Analysis; MR thru EMT-P)...so are EpiPens.

I'm not from NC, what exactly is a Medical Responder? Is that similar to a First Responder that will go in, and just sustain until a transporting unit can arrive?

 

[Christopher]

I'm not from NC, what exactly is a Medical Responder? Is that similar to a First Responder that will go in, and just sustain until a transporting unit can arrive?

The nomenclature is likely interchangeable with "first responder," excepting the fact that it is a recognized certification. It is an 80 hour class covering the bare minimum to provide medical care in the State. CPR/AED, splinting, first aid, immobilization/extrication, BGL, EpiPens, decon; you get the idea.

At least in my area they're not really found anymore as most of the first responder agencies (read: fire departments) have gone EMT-B minimum. This is because our county's medical director placed the minimum at EMT-B. Further, these EMT-B's are practicing at the full NC scope (BIADs, nasal narcan, etc).

 

[EpiEMS]

North Carolina sounds like a veritable EMS paradise!

I'd love to be able to take BGLs when I'm running without a medic. Technically, even with a medic, I'm not 'supposed to,' but they all expect it to get done, so who am I to say no (especially considering how easy it is to get)?

 

[Sandog]

North Carolina sounds like a veritable EMS paradise!

I'd love to be able to take BGLs when I'm running without a medic. Technically, even with a medic, I'm not 'supposed to,' but they all expect it to get done, so who am I to say no (especially considering how easy it is to get)?

Working out of your scope is what says no? Eh?

 

[heatherabel3]

I know this is an old post but I am cracking up. I knew going into this that as an EMT-B I would be limited on what I could and could not do in the way of patient care but seriously..a BGL? I just, like seriously 5 minutes ago, checked my kids sugar, it was low, gave him 2 glucose tabs, rechecked in 10, was fine, gave him some protein and sent him on his way and I had all of 8 hours of "Diabetes education" at the hospital.

And as far as giving glucose if their sugar is in the normal range isn't going to hurt anything. In the grand scheme of things your right but have you ever asked a Diabetic how they feel when their sugar goes up over 200 units in 10 minutes? Like crap, that's how. My son regularly gets off the bus with an awful stomach ache, headache, and begging for insulin because if the bus driver even thinks there is a chance he could be low she will give him a juice box. You are actually causing the patient more discomfort by giving the glucose if they don't need it than you would be by doing the 1/2 a second finger prick.

 

[JPINFV]

And as far as giving glucose if their sugar is in the normal range isn't going to hurt anything. In the grand scheme of things your right but have you ever asked a Diabetic how they feel when their sugar goes up over 200 units in 10 minutes? Like crap, that's how. My son regularly gets off the bus with an awful stomach ache, headache, and begging for insulin because if the bus driver even thinks there is a chance he could be low she will give him a juice box. You are actually causing the patient more discomfort by giving the glucose if they don't need it than you would be by doing the 1/2 a second finger prick.

In a situation where an EMT would give oral glucose to a known diabetic with an unknow BGL, "feeling like crap" is honestly going to be the least of the patient's symptoms.

 

[Brandon O]

Yeah, that's one of those silly rules that seems to be pretty standard...I mean...if you cause someone harm by checking a BGL, you've royally screwed up, and don't deserve your cert...:rofl:

Not sure if it counts, but I stuck myself with a lancet. Twice in one day.

Thought about having myself admitted for a CT. Or a psych workup...