Blood Glucose Measuring Devices in the Pre-hospital Setting Created by Boston EMS Edited by Central...

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Blood Glucose Measuring Devices in the Pre- hospital Setting Created by Boston EMS Edited by Central Mass EMS Corp. 2005

description

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

Transcript of Blood Glucose Measuring Devices in the Pre-hospital Setting Created by Boston EMS Edited by Central...

Page 1: Blood Glucose Measuring Devices in the Pre-hospital Setting Created by Boston EMS Edited by Central Mass EMS Corp. 2005.

Blood Glucose Measuring Devices in the Pre-hospital Setting

Created by Boston EMSEdited by

Central Mass EMS Corp.2005

Page 2: Blood Glucose Measuring Devices in the Pre-hospital Setting Created by Boston EMS Edited by Central Mass EMS Corp. 2005.

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 manufacturer’s instructions.

Page 3: Blood Glucose Measuring Devices in the Pre-hospital Setting Created by Boston EMS Edited by Central Mass EMS Corp. 2005.

PurposeTo 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

Page 4: Blood Glucose Measuring Devices in the Pre-hospital Setting Created by Boston EMS Edited by Central Mass EMS Corp. 2005.

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

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Indications for BG Measuring

Signs and Symptoms consistent with• Acute Stroke• Altered Mental Status

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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

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Altered Mental Status(Common Causes)AEIOU-TIPS

Alcoholism TraumaEpilepsy InfectionInsulin PsychiatricOverdose StrokeUnderdose

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Pre-Hospital Care (FOLLOW THE PROTOCOLS)

1. Scene Safety/Survey2. Perform initial assessment

May require airway control, definitely oxygen3. Ensure cervical spine immobilization as

indicated4. Activate ALS if necessary & available

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Pre-Hospital Care

5. Perform focused history and physical exam(a). SAMPLE history

1. Signs/Symptoms (when did they start?; how long did they last?)

2. Allergies3. Medications (When last taken?)4. Prior Medical History (diabetes?, seizure disorder?)5. Last oral intake (When did patient last eat)?6. Events leading to illness/injury

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Pre-Hospital Care

5. Focused history & physical exam, cont. (b). Take base line vital signs (c). Determine blood glucose level (d). Evidence of hypothermia/hyperthermia? (e). Can the patient swallow normally?

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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.

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Pre-Hospital Care

6. If patient is unconscious or seizing, transport on left side.

7. If patient’s BP drops below 100 systolic; treat for shock

8. Monitor VS every 5 minutes if unstable; every 15 minutes if stable.

9. Notify receiving hospital as soon as possible

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Glucose Measuring Devices• Used to Check Blood Sugar Levels• Many different types and models

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Procedures • Careful attention to BSI & safety• Select Finger• 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

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Device & Accessories

Glucometer

Test Strips

Lancet

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Glucose Measuring StepsStep #1 Step

#2

Locate Glucometer

Open Up Case

Step #3

Turn Power On

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Glucose Measuring Steps, cont.Step #4

Confirm Codes

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Glucose Measuring Steps, cont.

Step #5

Insert Test Strip

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Glucose Measuring Steps, cont.Step #6

Obtain Blood Sample

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Apply Drop of Blood

If inadequate up to 15 secs., add additional blood

Step #7Glucose Measuring Steps, cont.

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Glucose Measuring Steps, cont.Step #8

Document Results

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Some glucometers turn on automatically.Know the features of the glucometer your service uses.

Device Variations

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Results

• Normal blood glucose range is typically80-120 (fasting)

• Treat the patient, not the numbers

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Maintenance & Calibration

• Techniques• Frequency• Batteries• Care & Storage

– Device– test strips

• Documentation

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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

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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

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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)

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Questions?

• Ask your training officer• Consult your service Medical Director• Call your Regional office or visit their

website• Contact OEMS at (617)753-7300 or visit

http://www.mass.gov/dph/oems/oems.htm