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1. Blood Glucose Measuring Devices in the Pre-hospital Setting Created by Boston EMS
Modified by SEMAEMS One hour courseOne hour course
2. NOTE Information within this presentation should be tailored to the Blood Glucose Measuring Device used by the service and should include a review of the manufacturers instructions. SEMAEMS encourages its providers to use the Accu-Chek Compact Meter to allow for economy of scale purchases of testing supplies. Please contact the Regional Office for more Details.
3. Purpose To prepare currently certified EMT-Basics and Intermediates to utilize a Blood Glucose Measuring Device when operating under a licensed ambulance service and in accordance with A/R 5-520: Requirements for Basic and Intermediate EMT Use of Glucose Monitoring and the Massachusetts EMS Pre-Hospital Treatment Protocols
4. Objectives State when blood glucose measuring is indicated
Describe the importance of a full patient assessment in conjunction with test results
Demonstrate accurate calibration
Demonstrate appropriate procedures for measuring blood glucose
Explain proper maintenance, care & storage
5. Indications for BG Measuring Signs and Symptoms consistent with
Altered Mental Status
6. Acute Stroke Refer to the Acute Stroke Protocol
Utilize the Boston Operation Stroke Scale (BOSS)
Transport patient in accordance with the Stroke Point of Entry Plan
7. Altered Mental Status(Common Causes)AEIOU-TIPS Alcoholism Trauma
8. Pre-Hospital Care (FOLLOW THE PROTOCOLS)
1. Scene Safety/Survey
2. Perform initial assessment
May require airway control, definitely oxygen
3. Ensure cervical spine immobilization as indicated
4. Activate ALS if necessary & available
9. Pre-Hospital Care Perform focused history and physical exam
Signs/Symptoms (when did they start?; how long did they last?)
Medications (When last taken?)
Prior Medical History (diabetes?, seizure disorder?)
Last oral intake (When did patient last eat)?
Events leading to illness/injury
10. Pre-Hospital Care Focused history & physical exam, cont.
Take base line vital signs
Determine blood glucose level
Evidence of hypothermia/hyperthermia?
Can the patient swallow normally?
11. Pre-Hospital Care Do not administer anything orally if the patient does not have a reasonable level of consciousness and normal gag reflex.
Contact medical control prior to administering glucose to patients suspected of Acute Stroke.
12. Pre-Hospital Care If patient is unconscious or seizing, transport on left side.
If patients BP drops below 100 systolic; treat for shock.
Monitor VS every 5 minutes if unstable; every 15 minutes if stable.
Notify receiving hospital as soon as possible.
13. Glucose Measuring Devices Used to Check Blood Sugar Levels
Many different types and models
14. Procedures Careful attention to BSI & safety
Massage blood into distal end
Clean finger with alcohol & allow to dry
Use lancet or Auto-lancet device
Wipe first drop of blood off
Apply drop of blood onto test strip and follow individual glucometer instructions
Dispose of sharps and soiled supplies
15. Device & Accessories
16. Glucose Measuring Steps
17. Glucose Measuring Steps, cont.
18. Glucose Measuring Steps, cont.
19. Glucose Measuring Steps, cont.
21. Glucose Measuring Steps, cont.
23. Results Normal blood glucose range is typically
Treat the patient, not the numbers
24. Maintenance & Calibration Techniques
Care & Storage
25. BSI & Cleansing Issues Dispose of all sharps and blood contaminated materials properly
Cleanse only outside of monitor with general disinfectant (manufacturer approved)
Do not immerse/ inject/spray any liquid into device
26. Summary Indications for blood glucose measuring
Importance of a full patient assessment in conjunction with test results
Accurate calibration procedures
Appropriate blood glucose measuring procedures
Proper maintenance, care & storage procedures
27. Practice Session Students should complete a calibration procedure and test sequence under the direct supervision of an instructor
Students may practice obtaining a blood sample on each other or a thin skinned fruit (e.g., apple)
28. Questions? Ask your training officer
Consult your service Medical Director
Call your Regional office or visit their website http://www.semaems.com
Contact OEMS at (617)753-7300 or visit http://www.mass.gov/dph/oems/oems.htm