Blood Glucose Measuring Devices in the Prehospital Setting - PowerPoint PPT Presentation

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Blood Glucose Measuring Devices in the Prehospital Setting

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Blood Glucose Measuring Devices in the Prehospital Setting – PowerPoint PPT presentation

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Title: Blood Glucose Measuring Devices in the Prehospital Setting


1
Blood Glucose Measuring Devices in the
Pre-hospital Setting
  • Created by Boston EMS
  • Modified by SEMAEMS

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
  • Acute Stroke
  • 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
  • Epilepsy Infection
  • Insulin Psychiatric
  • Overdose Stroke
  • Underdose

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
  • SAMPLE history
  • Signs/Symptoms (when did they start? how long
    did they last?)
  • Allergies
  • 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
  • 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

15
Device Accessories
Test Strips
Glucometer
Lancet
16
Glucose Measuring Steps
Step 1
Step 2
Step 3
Locate Glucometer
Open Up Case
Turn Power On
17
Glucose Measuring Steps, cont.
Step 4
Confirm Codes
18
Glucose Measuring Steps, cont.
Step 5
Insert Test Strip
19
Glucose Measuring Steps, cont.
Step 6
Obtain Blood Sample
20
Glucose Measuring Steps, cont.
Step 7
Apply Drop of Blood
If inadequate up to 15 secs., add additional blood
21
Glucose Measuring Steps, cont.
Step 8
Document Results
22
Device Variations
Some glucometers turn on automatically. Know the
features of the glucometer your service uses.
23
Results
  • Normal blood glucose range is typically
  • 80-120 (fasting)
  • Treat the patient, not the numbers

24
Maintenance Calibration
  • Techniques
  • Frequency
  • Batteries
  • Care Storage
  • Device
  • test strips
  • Documentation

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
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