Glucometers For EMT's?

[DaveTFD 0]

a while back i heard something about EMT-B's being able to use glucometers soon. has anybody else heard about this, or have any more information about it? when is this going into effect?

[Guest]

I'm under the impression that this is voluntary much like Albuterol. As far as the training involved, last i heard was the state was coming up with a CME type of training for it. I know at work they already have the glucometers and have said they are going to train us themselves.

[ny10570 745]

The state approved the use of glucometers months ago. From there its is up to each region to develop their own procedures and policies for the agencies to follow. As of yet I haven't heard of anythign from Westchester.

[Jybehofd 85]

we were about to be one of the first ambulances with a glucometer but we have been held up by REMSCO... at least thats what I have been told. It will be a nice tool especially with the new protcalls for stroke patients.

[Guest alsfirefighter]

Jybe:

Would you please expand on your comment about it being nice for the stroke protocol?

Remember, while it doesn't hurt to have it, nothing replaces good solid assessment skills.

[Guest]

maybe hes talking about ruiling out hypoglycemia quickly....but the cincinati stroke test/general seizure assessment should zero you in pretty quickly

[WAS967 97]

Is there anything that specifically says that if an EMT comes upon a diabetic and they have a glucometer with them (the patient that is), that the EMT can't use it to test the patient's blood sugar?

[Guest]

there was nothing ever like that in the protocol for diabetic emergencies on the state level, westchester defaults onto the state protocol when it comes to BLS and i have not heard anything different thats why it appears to me that this whole glucometer thing will be handeled like Albuterol - the state establishes protocols and because Westchester defaults on the state's protocol they will allow it with registration or somthing like that (im just assuming that a BLS unit in Westchester needs to be registered to carry albuterol?).

[Jybehofd 85]

Jybe:

Would you please expand on your comment about it being nice for the stroke protocol? 

Remember, while it doesn't hurt to have it, nothing replaces good solid assessment skills.

←

Sorry ALS I thought that the glucometer was apart of the new stroke protcalls so that you can alert a stroke center and rule out the possiblity of low sugar. Sorry that I was being a little vague on it. But I do agree nothing bets a full assesent on the patient and to trust what the patient tells you.

[Guest Rich DD]

In New Jersey it is considered invasive, and not allowed. So... again, New Jersey will be last to approve it..... even though it could actually help a patient in some capacity.

[Guest alsfirefighter]

Thanks for clarifying. To add onto what WAS was asking, say you get a "normal" BS reading but on the low end or just shy of the 70 area. Do you withhold the oral glucose that a EMT-B carries? What if your not sure if it is a stroke or not with the same glucose readings as above?

My answers:

1. No you still give it. What if the calibration is off? What if the person is on the decline due to being at the high end of their therapeutic index of the insulin they are on and they will be reducing in glucose level as time goes on.

2. Nope again. You still give it. Oral glucose will not give you the same spike in blood glucose levels that D50 will. In fact many doctors who have spoken about this always say, what do you do if the person is having a stroke and their glucose is very low? You can't survive without 2 things. Oxygen and glucose. And most consensus is even an amp of D50 will not be very harmful. Bottom line is this, when you are not sure, you call medical control and put it into their hands. Even if a maching is telling you one thing, the patient can be telling you another, I go with the signs and symptoms. The machine could be wrong, the person taking the BS could have not done it correctly. Even alcohol from a prep pad can cause an effect.

Treat your patients brothers and sisters not your machines. I still have people not taking manual blood pressures first or using a pulse ox for pulse rates. This is unacceptable and dangerous.

[WAS967 97]

I still have people not taking manual blood pressures first or using a pulse ox for pulse rates. This is unacceptable and dangerous.

I'll drink to that! [glug glug]