Blood Glucose Measuring Devices in the Pre-hospital Setting Created by Boston EMS Edited by Central...
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![Page 1: Blood Glucose Measuring Devices in the Pre-hospital Setting Created by Boston EMS Edited by Central Mass EMS Corp. 2005.](https://reader036.fdocuments.us/reader036/viewer/2022062311/5a4d1b0a7f8b9ab05998a598/html5/thumbnails/1.jpg)
Blood Glucose Measuring Devices in the Pre-hospital Setting
Created by Boston EMSEdited by
Central Mass EMS Corp.2005
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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.
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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
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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