BGL protocols for EMTs

[EMT B]

people argue for one reason or another that it does not change your course of treatment at the BLS level

 

[heshyh]

people argue for one reason or another that it does not change your course of treatment at the BLS level

It can In many cases e.g. ams with able to follow commands.
But either way , even unresponsive patient. Why should the medics have to start from scratch with an assessment of the emt can give it (at least in a diabetic case)

 

[EMT B]

ive heard people argue that any AMS pt with an open airway can get a tube of glucose and not need an immediate BGL, because you should have ALS en route anyway. They defend that by saying that if even if the patient is hypoglycemic, 15g of sugar wont make them much worse, and that if it isn't diabetic related, then 15g of sugar still wont hurt.

 

[Kevinf]

In PA it is an ALS skill... though BLS has oral glucose as standard equipment. Sure you don't necessarily need a gadget to diagnose low blood sugar, but I still think it's funny that we stock BLS rigs with glucose but not glucometers.

 

[yowzer]

Not all of WA state. More specifically, not King county.

Not Seattle, you mean. Every other fire department in the county that I'm aware of has EMTs checking sugar. SFD is the one that is singled out in our protocols to not be able to test it.

 

[TheLocalMedic]

Here BLS cannot assess BGL (or pulse oximetry, but that's another thread…) without a prescription from the county medical director.

Should they be allowed to do it? Absolutely.

Is there a need for them to have it? Here, not so much. Most fire departments here run ALS or have an ALS ambulance available quickly. We don't run BLS 911 cars.

 

[Mariemt]

In PA it is an ALS skill... though BLS has oral glucose as standard equipment. Sure you don't necessarily need a gadget to diagnose low blood sugar, but I still think it's funny that we stock BLS rigs with glucose but not glucometers.

Our medical director wouldn't want us shoving glucose in the mouth of all stroke victims, brain bleeds etc.
We use it to diagnose blood sugar yes, but also to rule out things such as strokes.

 

[Household6]

This subject just blows my mind how some areas are so touchy about it.. BGL checking is an EMR skill here. As an EMT I'm allowed to administer oral glucose, as long as the patient can swallow and has control of their airway..

It's a pretty simple protocol. Can the patient swallow? No? Then they don't get glucose.

Criminy, we're even told by our bossman to stick around and help the hypoglycemic patient make some food if they refuse transport.. Eggs and toast is what we usually make, or a bowl of cereal.