BLS and Glucometers

[AnthonyM83]

Once again, I'll post my reasons;

It was one of the things we were trained in during EMT class. Yes, the training was minimal, but so was the training in most everything else we do. It's all just algorithms for EMT, anyway. So, why not this?

Someone asked how it would affect treatment.

*If you have a mildly altered person, you can check sugar and have a direction to approach the rest of your assessment and treatment with (for those who can follow basic commands and swallow glucose, but are still confused).

*It's also just more that's taken care of when ALS arrives (not a big deal, but when patient is totally out, can rule at least one thing out)

*If you work with a medic partner, he can concentrate on his assessment and you can do the manual stuff along with BPs and gathering meds or whatever else, instead of spending time poking fingers.

Some of these were touched on, but not really. If it's ALOC, ALS is going to be dispatched. If you have crews waiting around to see WHY he's ALOC before calling ALS, you have a different problem unrelated to being able to have a glucometer.

When you have other non-medics on-scene like FD, they can get right to glucose and VS and monitor, while medics go for IV. If it's only EMT and Medic and you have high suspicions for hypoglycemia (family saying he was acting as if sugar low or whatever), EMT might go straight for BGL (takes a minute).

I'm not trying to prove an EMT NEEDS it, because we obviously don't since so many areas don't have them. I'm just showing how in practice it actually can be useful having that in one's scope.

[Dustdevil]

Isn't that like withholding pain management from the abdominal pain patient?

Did you really just attempt to compare checking a blood sugar reading with providing analgesia?

Congratulations. You just beat out the previous record holder for the most pointless, irrelevant, and invalid analogy ever posted on EMT City.

[akroeze]

Did you really just attempt to compare checking a blood sugar reading with providing analgesia?

Congratulations. You just beat out the previous record holder for the most pointless, irrelevant, and invalid analogy ever posted on EMT City.

I disagree Dust. It seems to me he is trying to say you are withholding treatment so it doesn't "screw up" the doc's assessment like they used to say with analgesia for ABD pain.

[AMESEMT]

From a diabetics point of view now........

Taking a glucose = easy and can be done in less than a minute by anyone. I have had my mother do it for me once and she never has done it for me and it took her like 45 seconds. I would expect most basics (depending on the machine) could manage that in less time. I do it in about 10 (since my personal machine is quick and I do it at least 4 times a day). Depending on if they have to wait for ALS or are meeting them in route you can do it while waiting or en route to the hospital/where you are meeting ALS. All it does it provide a means for ruling out hypoglycemia and not necessarily how you are treating the patient. Like Backinboston said, it is a tool of assessment.

[Dustdevil]

I disagree Dust. It seems to me he is trying to say you are withholding treatment so it doesn't "screw up" the doc's assessment like they used to say with analgesia for ABD pain.

I understood that. However, any attempt to compare a lab test reading, that provides the patient with no benefit, with a pharmacotherapeutic treatment measure that relieves serious patient distress is a FAILure. Not even in the same ballpark.

The only valid comparison of the two is this: one provides a benefit to the patient. The other one does not.

[stcommodore]

So the national (draft or whatever status) considers treatment with Dextrose/assessment of a BGL to be an ALS skill and we are still debating the point? The problem here is that people at the BLS level have had the definition of BASIC care blurred with medication, intubation, IV, etc and forgot the purpose of there care. Stabilization of immediate life threats, and rapid transport to hospital or with advanced care if circustances allow.

[Dustdevil]

The problem here is that people at the BLS level have had the definition of BASIC care blurred with medication, intubation, IV, etc and forgot the purpose of there care. Stabilization of immediate life threats, and rapid transport to hospital or with advanced care if circustances allow.

Good point. Although, if it were up to me, I'd take transportation away from basics too.

Ooooh! In fact, that's a good idea! Just make paramedic the minimum level to drive an ambulance, and suddenly, basic ambulances will disappear overnight. Seems easy to me. You'd think that the Department of TRANSPORTATION would have figured that one out a long time ago, if they took their name seriously. Funny how they have spent nearly four decades, and written volumes upon volumes about MEDICAL CARE, but have so far FAILED to adequately address TRANSPORTATION.

But yeah, this is indeed a symptom of what you refer to. Always trying to do more with less. We get so impressed with ourselves for doing more with less that we totally stop trying to simply get more to begin with. People are actually patting themselves on the back for getting glucometers in their EMT bags because there are no paramedics in the system, but I would be willing to bet that none of those people ever went to the city or county to demand paramedics to begin with.

Back-asswards half-stepping. This is not progress.

[stcommodore]

I have no issue with there being a BLS and ALS level. My only issue is when they try and play around with some level(s) in the middle. There is always some laundry list of reasons why BLS can't do it, needs to do it, they can't get medics, there aren't enough medics, etc. Simply on the topic I'll say over and over BLS does not equal BGL.

[Dustdevil]

I have no issue with there being a BLS and ALS level. My only issue is when they try and play around with some level(s) in the middle.

Exactly. This blurring of the lines is not progress.

And I too have no issue with there being a BLS and ALS level. So long as the BLS level is not allowed on an emergency ambulance.

[mrmeaner]

Well, if EMS was to be taken seriously, the NHTSA wouldn't have anything to do with it to begin with.