Discussion in 'EMS Talk' started by Caspar, Jan 7, 2017.
If a patient is a nondiabetic and is exhibiting signs of hypoglycemia, can you give oral glucose?
Is this a homework/ test question?
This is most likely going to be a state by state type of answer, as all protocols aren't created equal.
In my state(MA), if you work for s service not carrying glucometers(really guys, its 2017. Get with it), you could as the indications for its use don't require a known Hx of hypoglycemia, only the presentation of hypoglycemia. The protocols specifically mention Tx of 70mg/do and below, but I know there are still services out there unable to asses that. Keep in mind that nobody was a diabetic until they were, so its possible you just happen to be encountering this patient as they experience this wonderful disease for the first time.
If they have low blood sugar. Sure.
If they're NOT a diabetic, chances of them being hypoglycemic are pretty low. Go back in your book and look up the differentials for altered mental status and tell us why it's NOT appropriate to give a non diabetic oral glucose.
No I had a patient like this. Bgl was in the 40s, near syncope
Then, yes, if they can tolerate (intact gag) swallowing sugar 'em up.
Ahh, the good old AEIOU-TIPS.
The phrase "exhibiting signs of hypoglycemia" gives me the anger Are they hypoglycemic or not? What sad pathetic joke of a company doesn't give their EMT-B's glucometers?
If the posts I've read on this forum are representative, most of California...
Why even have BLS ambulances? Give Uber drivers an AED and bottle of O2, call it "UberMed", I bet your outcomes will be about the same.
Not all ambulances in California even carry AEDs so your UberMed concept is already winning.
The highly invasive skill of BSG is only entrusted to our highly trained paramedics in my county
Hey man, we can't just be letting basics do these invasive procedures on people. They might bleed uncontrollably. Too much risk.
Didn't "UberMed" force their own thread to close on here?...
I see what you did there, Jimbo.
Marion Co, Indiana (city of Indy) JUST now has granted EMTs the ability to use glucometers. Yes, really. It's brand-spanking new, and we have to do *both* an online training course and a hand's-on to get signed off to actually use it.
Pennsylvania as well.
Misery loves company.
I as a paramedic must be present to supervise my EMT in obtaining a BGL. You know, incase they try to poke the patients eye... those darn EMTs.
Anyways, beyond the ridiculousness of an over the counter test non medically trained lay persons are expected to perform on themselves regularly being to invasive for EMTs in many areas....circling back to the OPs question, what I was taught was that if you had a patient who you believed to be hypoglycemic to give sugar (as long as their alert enough to eat a tube of our oral glucose) as its harder to hurt someone with too much sugar, vs someone can rapidly deteriorate and even die with a too low sugar. At least that was what was taught in EMT class (alongside such gems as every ACS or ALOC pt should be placed on high glow O2)
If you are not diabetic it is not physiologically possible to become symptomatically hypoglycaemic, unless of course, you've poisoned yourself with a medicine capable of doing this (for example insulin), you are a child under five years of age with significant infection, or you have a giant insulinoma.
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