Orange PD on CMED this am 6/3/08

[joetnymedic]

Heard OPD (Orange 101) on med 10 this am for a diabetic. They were giving CMED and Medic 33 plus the rig an update on the pt. Only heard this once before awhile back. Is this going to be happening more often? How many other departments have the ability? and How will they ID themselves if they do?. Also on a seperate subject, not related to radio, the unit that called in to CMED stated the pt. had a sugar level of 30. Does the PD have the abilty to do finger sticks, is it in the protocols, and exactly what can they do for treatment on scene? I know it's alot of questions, but after hearing this stuff this am, I'm interested.

 

[KB1JHU]

OPD are first responders for EMS calls. Not sure what certification level they have, if any at all. I have heard them on CMED a number of times in the past, mostly on MVAs. As far as the blood glucose level, the patient probably checked their own. As far as I know right now, only medics (maybe EMT-I) can do a finger stick. Some people are pushing for protocol changes to allow EMT-Bs to do them with the justification that if someone can do it themselves, why can't an EMT.

 

[jb872033]

yeah...the whole finger prick thing never made sense to me...although if somoene has their own glucometer, i have heard of emts asking patients to do it...which is 100% procedurally correct but sometimes diabetic symptoms mask other things as well so its good to get a blood sugar reading asap and plan treatment around that...


JB

 

[izzyj4]

I used to work full time at C-MED New Haven and it was always a pleasant surprise to hear OPD 101 or 108 on "10". I don't know if they are MRTs or EMT level but I know OPD first responds to everything. I would have to believe that the patient had a gulcometer <sp> and they utilized it. As of right now I do not beleive OPD has such a unit yet that I know of.

 

[mlevin]

As of last year, CT now allows EMT-Bs to do finger sticks. There is reason not to, it is so easy and makes the world in deciding how your are going to treat the patient.

 

[KB1JHU]

As of last year, CT now allows EMT-Bs to do finger sticks. There is reason not to, it is so easy and makes the world in deciding how your are going to treat the patient.

I just looked it up and it looks like the local sponsor hospital has to approve the use of glucometers.

http://www.ct.gov/dph/lib/dph/ems/pdf/glucometry.pdf

The State of Connecticut has given authority for CEMSMAC to approve the utilization of glucometers for testing and monitoring the blood glucose levels by EMT- Basics and Intermediates under statute 05-259. The utilization is only under the auspices of the local services’ sponsor hospital medical director and is not intended to be construed as being set forth as protocol for all EMTs. The sponsor hospital programs utilizing blood glucose monitoring must have written policies and protocols for their services and providers as well as a quality assurance program in place. The services will need to follow the policy as set forth by OEMS for approval, which includes, but not limited to, updated MIC applications and appropriate training.

I guess it's a matter of convincing the local medical director to allow it. I don't think EMT's in regions 1 and 2 (southwest & south central) can do glucometry.

 

[N1SQB]

Its not that complicated!

I am a diabetic!
I understand what is involved in doing blood sugar sticks. There is no complication what so ever. What is the point in not allowing an EMT to do it? I mean really, lets ask the question, what is the real reason why it is not allowed? If an EMT can gather that information quicker instead of waiting for a medic to show up, while someone like myself may be on the ground unconscious, I want him/her to have that ability. Seconds may make the difference between someone living or dying.

Manny

 

[KB1JHU]

I am a diabetic!
I understand what is involved in doing blood sugar sticks. There is no complication what so ever. What is the point in not allowing an EMT to do it? I mean really, lets ask the question, what is the real reason why it is not allowed? If an EMT can gather that information quicker instead of waiting for a medic to show up, while someone like myself may be on the ground unconscious, I want him/her to have that ability. Seconds may make the difference between someone living or dying.

Manny

I think the original reason is that apparently poking a little hole in someone's finger is considered an invasive procedure. EMTs in southwestern and south central CT can't do a lot of things that EMTs in more rural areas of the country can do because the medical directors feel that there are enough hospitals close by that it is not necessary for them to do certain things. The doctors prefer that EMTs just load people in and get to the hospital.

 

[dittrimd]

Interesting to hear PD on CMED calling in PT info. Our PD responds but just act as First responders on scene till fire and EMS get there.

As for glucometers and finger sticks, here in North Central we can now do finger sticks. The only problem is that as EMT Basics it does not change our treatment of the patient in any way so why put the time and effort into it. If the patient in unconcious not protecting airway you do ABC's regardless of BGL. If concisous and protecting their airway you get them to eat something or oral glucose. These are the same treatements before glucometers so why? Most medics are going to take their own BGL prior to giveing D50 becuse the do not trust basics and their meters are usually better and they have stricter Q/A checks. Once per shift vs. once per month. Basics are there for intinial patient assessment and transport. It use to be that I could dump two tubes of glucose down a patient off line. Now becuase of the new protocols for BGL I have to call med control for "orders" for the second tube and report the BGL. It is now adding time to our treatment rather than making it quicker. I say let the medics take care of the other stuff.

It is the same with Pulse oximetry. Total waste for Basics. What does pulse oximetry do as far as effecting treatement. Absolutely nothing. Pink is good blue is bad. Anyone in respirator distress gets O2 except maybe for hyperventilators. If anything I have seen it do more harm that good. You get basics who think well he has a pulse on the meter so why check it. Guess what, no palpable pust. Ooops!!

Sorry to rant off topic but can you tell this stuff bothers me.

 

[N1SQB]

Not Ranting, no problem!

Its cool!
We all need to hear / learn from you guys/gals whom we depend on in time of need. You're never too old to learn, at least thats how I think!!

Manny

 

[SP101]

When North Branford PD upgraded from MRT to MRT with debfibriilator some time ago, they added Med 10 and 6 to the PD UHF portables. The idea was to give them med control. They would sign on as 1-India-[badge #]. Patrolmen in that town use 500 series badge numbers on the air.