BGL protocols for EMTs

[JakeEMTB]

What are the protocols for EMT use of glucose meters in your area? I'm from NJ where it's not allowed (we can obtain from patient or family if they take it and report results to us). I have to write a report about it and how its standards differ between the states.

 

[DesertMedic66]

For my area the paramedic or AEMT has to direct the EMT to get the results. So after the medic or AEMT tells us, we can test it.

 

[nwhitney]

Obtaining a blood sugar is within the EMT scope here in Oregon.

 

[yowzer]

It's a per-agency decision, with the exception of the largest fire department in the county, which the county-wide protocols explicitly ban from doing glucose readings at a BLS level. Every other fire department in the county, as far as I know, allows and does them on a regular basis. Private ambulance companies don't, which makes no sense to me since they can easily recoup costs by billing for it.

 

[Mariemt]

I take a BGL on all altered patients, all possible strokes, all possible intoxicated pts or all diabetics not "feeling good "

I don't need approval and we never, ever use the patients own monitor or strips

 

[rescue1]

In Maryland it's a BLS skill, though I think it still depends on the individual county protocols.
In PA it's an ALS only skill.

 

[TransportJockey]

BLS skill here in nm. I believe even first responders may do it.

 

[ZombieEMT]

I also am from New Jersey and of all the messed up standards we follow, I think BGL is the worst. It is a simple procedure which can go a long way in patient assessment. I can tell you that many EMTs in the county that I work in, will "Assist" a patient with obtaining a BGL even when unconscious, if you catch my drift.

 

[EMT B]

Any patient that is altered mental, or any patient with a fever gets a BGL from me. Both states I work allow BGL at the BLS level

 

[chaz90]

any patient with a fever gets a BGL from me

What's your reasoning for this?

 

[Christopher]

What are the protocols for EMT use of glucose meters in your area? I'm from NJ where it's not allowed (we can obtain from patient or family if they take it and report results to us). I have to write a report about it and how its standards differ between the states.

It is a medical responder skill in North Carolina, and is commonly taught as part of first aid classes. I actually can't think of a level of medical provider who cannot assess a BGL in NC.

Even our police will grab it if they get there before we do on an unconscious diabetic (using the family's meter).

 

[heshyh]

I take a BGL on all altered patients, all possible strokes, all possible intoxicated pts or all diabetics not "feeling good "

I don't need approval and we never, ever use the patients own monitor or strips

Which state are you from? And. Is it allowed in your state, or this is what you do?

 

[EMT B]

What's your reasoning for this?

depending on the severity of the fever, they will get both a BGL and a Lactate to check for SIRS/Sepsis

i usually do both off of the IV cath so that im not sticking the patient 2-3 different times

EDIT: plus, a fever increases your metabolic rate, so we need to make sure they are getting adequate amounts of sugar

 

[usalsfyre]

EDIT: plus, a fever increases your metabolic rate, so we need to make sure they are getting adequate amounts of sugar

You're overthinking that one, typically patient's who are in any kind of shock will show a slightly elevated BGL. That does not mean however, the cells are able to appropriately metabolize that glucose.

 

[chaz90]

depending on the severity of the fever, they will get both a BGL and a Lactate to check for SIRS/Sepsis

i usually do both off of the IV cath so that im not sticking the patient 2-3 different times

EDIT: plus, a fever increases your metabolic rate, so we need to make sure they are getting adequate amounts of sugar

It seems like you already realize this, but all that is fever isn't sepsis. Furthermore, what correlation do you expect to find between running a BGL on even obviously septic patients? As usalsfyre mentioned, many will have slightly elevated serum glucose levels, but it's certainly not reliable as a diagnostic criteria. And yes, illness often increases metabolic rate, but not to the point that it consumes so much extra sugar that it becomes uncompensated. How many patients have you checked a blood sugar on due to fever and found something that needed to be treated pre-hospitally or significantly added to your assessment information?

To put my two cents in on the original topic of this thread, blood glucose checks are an EMT level skill in Delaware. All BLS ambulances carry glucometers and they're fairly good about checking quickly.

 

[IslandTime]

I take a BGL on all altered patients, all possible strokes, all possible intoxicated pts or all diabetics not "feeling good "

I don't need approval and we never, ever use the patients own monitor or strips

Same here. WA state.

 

[NomadicMedic]

Same here. WA state.

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

 

[Mariemt]

Which state are you from? And. Is it allowed in your state, or this is what you do?

Iowa, it is a local protocol. Not state. Most areas around here do not allow it. Our medical director has included it.

 

[EpiEMS]

Are there any plausible reasons for which BGL should not be include in the EMR and EMT scope? It's quite low risk and potentially high benefit, no?

 

[nwhitney]

Are there any plausible reasons for which BGL should not be include in the EMR and EMT scope? It's quite low risk and potentially high benefit, no?

I see no reason why this shouldn't be included in the scope for EMR and EMT.