I was wondering how many states allow EMT-B to assess the BGL. In California, at least in San Diego, it is considered invasive. With the rise in the diabetic population I would consider taking a BGL as part of vitals. What's your take on this?

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In Washington State it's allowed at the EMT-B level, but up to the county MPD whether or not EMTs in that county can actually do it. In my first county, EMTs were not allowed - period. The rationale by the MPD was that it would not change the treatment at the BLS level, which was to give oral glucose to any patient with a gag reflex or upgrade to ALS for altered LOC (it was a two-tiered system). All it would do was delay the inevitable treatment if the level was checked before the glucose was administered. (He had the same argument against letting EMTs check Pulse Ox. "If you need a machine to tell you the patient needs oxygen . . . ")  In my current county, blood glucose check is standard protocol even at the BLS level for known diabetics or anyone with an altered LOC.

Not allowed in PA yet.  I think that's OK, because glucometers are known for being unreliable at very high and very low levels (usually <40 and >400)  In the hospital you would double check these levels with a lab test.  You will never kill anyone with sugar, and you can't give insulin or IV fluids anyway.  EMTs should be able to tell a person is at risk of having a low blood sugar and give sugar if that risk exists.  That said...if they make them legal I will buy one for the ambulance.

When I was trained in New york your allowed to do if you feel there is a reason to, but in Mass, you have to be paramedic or have been trained and the waiver been signed by the medical director, last I recall.


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