Transcript Blood Glucose Measuring Devices in the Pre

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.
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
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
Indications for BG Measuring
Signs and Symptoms consistent with
• Acute Stroke
• Altered Mental Status
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
Altered Mental Status
(Common Causes)
AEIOU-TIPS
Alcoholism
Epilepsy
Insulin
Overdose
Underdose
Trauma
Infection
Psychiatric
Stroke
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
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. Allergies
3. 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
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?
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.
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
Glucose Measuring Devices
• Used to Check Blood Sugar Levels
• Many different types and models
Procedures
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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
Device & Accessories
Test Strips
Glucometer
Lancet
Glucose Measuring Steps
Step #1
Step #2
Step #3
Locate Glucometer
Open Up Case
Turn Power On
Glucose Measuring Steps, cont.
Step #4
Confirm Codes
Glucose Measuring Steps, cont.
Step #5
Insert Test Strip
Glucose Measuring Steps, cont.
Step #6
Obtain Blood Sample
Glucose Measuring Steps, cont.
Step #7
Apply Drop of Blood
If inadequate up to 15 secs., add additional blood
Glucose Measuring Steps, cont.
Step #8
Document Results
Device Variations
Some glucometers turn on automatically.
Know the features of the glucometer your service uses.
Results
• Normal blood glucose range is typically
80-120 (fasting)
• Treat the patient, not the numbers
Maintenance & Calibration
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Techniques
Frequency
Batteries
Care & Storage
– Device
– test strips
• Documentation
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
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
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)
Questions?
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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