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MEMS GLUCOMETER TRAINING

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Indications for BG Measuring Signs and Symptoms consistent with Acute Stroke Altered Mental Status Known Diabetic Patient Trauma with potential for Head/Spinal ... – PowerPoint PPT presentation

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Title: MEMS GLUCOMETER TRAINING


1
MEMS GLUCOMETER TRAINING
  • MEMS Education Committee
  • 2008

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.

3
Purpose
  • To prepare currently certified and future
    EMT-Basics to utilize a Blood Glucose Measuring
    Device under current MEMS Protocol Standards.

4
Objectives
  • At the conclusion of this program participants
    will be able to
  • 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
  • Understand the need for a CLIA Waiver

5
Indications for BG Measuring
  • Signs and Symptoms consistent with
  • Acute Stroke
  • Altered Mental Status
  • Known Diabetic Patient
  • Trauma with potential for Head/Spinal Injury
  • Combative Patient
  • Seizures
  • Overdose
  • ETC

6
Altered Mental Status(Common Causes)AEIOU-TIPS
  • Alcoholism Trauma
  • Epilepsy Infection
  • Insulin Psychiatric
  • Overdose Stroke
  • Underdose

7
Pre-Hospital Care
  • (FOLLOW THE PROTOCOLS)
  • 1. Scene Safety/Survey
  • 2. Perform initial assessment
  • Considering/Treating ABCs
  • 3. Ensure cervical spine immobilization as
    indicated
  • 4. Activate ALS-ALS must be activated when using
    the glucometer.

8
Pre-Hospital Care
  • 5. Perform focused history and physical exam
  • (a). 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

9
Pre-Hospital Care
  • 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?

10
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/Head/Spinal Injury.

11
Pre-Hospital Care
  1. If patient is unconscious or seizing, transport
    on left side.
  2. If patients BP drops below 100 systolic treat
    for shock
  3. Monitor VS every 5 minutes if unstable every 15
    minutes if stable.
  4. Notify intercepting ALS service/provider

12
Glucose Measuring Devices
  • Used to Check Blood Sugar Levels
  • Many different types and models

13
Procedures
  • Careful attention to BSI safety
  • Select Finger
  • Massage blood into distal end
  • Clean finger with appropriate aseptic technique
  • (if using alcohol, let dry or wipe dry with
    sterile gauze)
  • Use lancet or Auto-lancet device
  • Apply drop of blood onto test strip and follow
    individual glucometer instructions
  • Dispose of sharps and soiled supplies in
    appropriate container

14
Device Accessories
Test Strips
Glucometer
Lancet
15
Glucose Measuring Steps
Step 1
Step 2
Step 3
Locate Glucometer
Open Up Case
Turn Power On
16
Device Variations
Some glucometers turn on automatically. Know the
features of the glucometer your service uses.
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
Results
  • Measured in milligrams per deciliter
  • Normal blood glucose range is typically
  • 80-120 mg/dl (fasting)
  • Treat the patient, not the numbers

23
Maintenance Calibration
  • FOLLOW MANUFACTURERS RECOMMENDATIONS
  • Techniques
  • Frequency
  • Batteries
  • Care Storage
  • Device
  • test strips
  • Temperature Can Affect Machine Accuracy!!!!

24
Documentation
  • Reasons for procedure
  • Time of procedure
  • Results of procedure
  • Response to treatments
  • Changes in signs/symptoms

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
CLIA WAIVERS
  • Required for all services using a glucometer
  • The Centers for Medicare Medicaid Services
    (CMS) regulates all laboratory testing (except
    research) performed on humans in the U.S. through
    the Clinical Laboratory Improvement Amendments
    (CLIA).
  • The objective of the CLIA program is to ensure
    quality laboratory testing.

27
CLIA WAIVERS
  • There is a Biennial Fee of 150.00 for this
    waiver
  • An application for a CLIA Waiver can be obtained
    by going to
  • http//www.cms.hhs.gov/clia/
  • This must be filled out by all services intending
    to use glucometers, whether they are volunteer or
    paid.
  • Or call Margaret Naas, Bureau of Health, and
    request application, 287-9339

28
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
  • CLIA Waiver Compliance

29
Practice Session
  • Students should complete a calibration procedure
    and test sequence under the direct supervision of
    an instructor
  • Demonstrate proper technique for obtaining a
    Blood Sugar correctly.
  • Showing proper aseptic technique
  • Sharps disposal

30
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