Obtaining BGL

[SeanEddy]

California doesn't have a statewide protocol.

Your right, they don't have a "statewide protocol" per-se, but they DO have a minimum and maximum scope of practice. The county medical directors essentially have a list of skills and medications to choose from. Anything outside of that can't be added without doing an approved study to prove the benefit and necessity.

The county I worked in fought tirelessly for years to get stuff added. It's a horrible system with way too much red-tape and politics to get through.

 

[Monkadelic]

It's out of scope of practice here in NE MS- a lot of things are :sad: Also MS decided to nerf AEMT because the board believed it takes away from the paramedic- ie. everyone will hire AEMTs instead so they can pay them less... etc. You gotta go to TN for an advanced certification- that is the closest place I seen to us. I can't understand why they don't go to a national scope of practice since you have to know everything for registry anyways, but can only do half the things you are taught varied by the area you are in... I just don't get that train of thought by the higher ups. Can anyone enlighten me more on that? Power struggles vs control nuts? etc?

 

[Handsome Robb]

It's out of scope of practice here in NE MS- a lot of things are :sad: Also MS decided to nerf AEMT because the board believed it takes away from the paramedic- ie. everyone will hire AEMTs instead so they can pay them less... etc. You gotta go to TN for an advanced certification- that is the closest place I seen to us. I can't understand why they don't go to a national scope of practice since you have to know everything for registry anyways, but can only do half the things you are taught varied by the area you are in... I just don't get that train of thought by the higher ups. Can anyone enlighten me more on that? Power struggles vs control nuts? etc?

Catering to the lowest common denominator.

Why do you think many places in CA still make medics call for orders all the time?

Also having state/county departments governing EMS generates income for that state or county.

 

[Monkadelic]

Catering to the lowest common denominator.

Why do you think many places in CA still make medics call for orders all the time?

Also having state/county departments governing EMS generates income for that state or county.

yeah that sounds about right to me.... but it's still ridiculous imo. a person schooled and trained in interventions and emergencies is considered lower in standards than the person that has not been trained to do the simple things themselves to prevent a call to EMS. Seems like a catch-22 in all reality- ie... you HAVE to know this; but you CANT do it! lol April fools! here's your certificate! via con dios!

 

[BearChicago]

We use them in IL. Very handy. I'll do it as indicated, and on every almost every run going to the ED as well, because 99% of the time the hospital will ask for one.

 

[Christopher]

I can't understand how POC blood glucose measurement is not the Standard of Care. It's at the medical responder level in NC.

If I were an enterprising lawyer I'd sue

 

[Anjel]

Just thought I would throw Michigan into the places EMTs can do BGLs.

We have three glucometers in our truck at the moment.

 

[emt_irl]

in ireland emt's can do bgl but we can use oral glucose and glucogon i.m to do something about a low bgl reading

 

[oshawamedic]

in ontario we do

 

[bstogner]

Our medical control allows it. They actually advise us to do it on any pt we deem necessary.

 

[jjesusfreak01]

in ireland emt's can do bgl but we can use oral glucose and glucogon i.m to do something about a low bgl reading

And while at first glance, it would appear reckless to allow EMTs to do Glucagon injections, hypoglycemia (usually) doesn't fix itself and can progress to badness quickly, while BGLs and IM injections are actually quite easy to do.

 

[Medico]

In a VA EMT-B can check BGL as well as administer SL nitro for chest pain, obtain 12-lead, put pt on cpap, place king or LMA, and administer duo nebs.

 

[Talonrazor]

Here at my agency, BGLs are part of our vitals and are taken on every patient by my EMT-Bs and EMRs.

 

[NomadicMedic]

Here at my agency, BGLs are part of our vitals and are taken on every patient by my EMT-Bs and EMRs.

Every patient? Seems kind of pointless to me. I only take them when indicated.

 

[Talonrazor]

Every patient? Seems kind of pointless to me. I only take them when indicated.

Has to do with our population. We are a public inebriation enforcement agency. Our units pick-up any public inebriate or intoxication due to drugs and transfer them to our detention facility, where they stay for 12 hours. Due to this, we deal with a huge amount of "street folks". And almost all of them have diabetic issues due to lifestyle. Every patient we deal with is "AMS". So we have to rule out AMS due to other issues than ETOH. BGLs, narcotics, HEENT etc.

Every time the FD pulls up to perform ALS transfer to a hospital, they ask for BGLs.

 

[emt_irl]

And while at first glance, it would appear reckless to allow EMTs to do Glucagon injections, hypoglycemia (usually) doesn't fix itself and can progress to badness quickly, while BGLs and IM injections are actually quite easy to do.

well we wouldnt treat and discharge. they'd get it while waiting for als or on the way to the ed thankfully. i dont think id like to rely soley on the process of glycogeniosis if i were a diabetic.

we'd usually check bgl in all unresonpsive patients, all patients who werent gcs15 and post seziure patients.

 

[NomadicMedic]

Has to do with our population. We are a public inebriation enforcement agency. Our units pick-up any public inebriate or intoxication due to drugs and transfer them to our detention facility, where they stay for 12 hours. Due to this, we deal with a huge amount of "street folks". And almost all of them have diabetic issues due to lifestyle. Every patient we deal with is "AMS". So we have to rule out AMS due to other issues than ETOH. BGLs, narcotics, HEENT etc.

Every time the FD pulls up to perform ALS transfer to a hospital, they ask for BGLs.

Well, that certainly makes good sense. I was under the impression you were just finger sticking everybody.

 

[EMSANTHEM]

In CT it's no big deal

glucometer readings are done by emt-b's here all the time on BLS and ALS calls you don't have to have a medic present or sign anything if you have a emt card you do it just of course have all your region classes completed

 

[Altered Mental Status]

In Alabama it is. BGL is considered part of V/S.

 

[Bullets]

there are 2 reasons we cant check BGL in NJ, and they are totally different


1.) If the patient is unresponsive, then i can check their BGL and maybe rule out a CVA, but otherwise my treatment does not change. If the patient is responsive then they can check their own BGL and i can treat with oral glucose.

2.) If EMTs are allowed to check BGLs, we can effectivley rule in/out a CVA. Now i "need" medics for any altered or unresponsive patient. If i can check their BGL and they are hyPOglycemic, then i need ALS, if the are normal then i can rule in a stroke, and i technically dont need ALS, just a hospital. EMTs could effectively cut their ALS requests significantly

NJ is still largely served by volunteers, so even though a patient may be transported in a BLS truck, the ALS service is the only one who is billing, so they get the money. If BLS can check BGL and thus cut down on ALS requests, then ALS loses money, and the ALS projects simply wont allow that

ALS is far more organized then BLS in this state