Gluco Meter Training Program

8/3/2019 Gluco Meter Training Program

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MEMS GLUCOMETER TRAINING

MEMS Education Committee

2008



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 and future

EMT-Basics to utilize a Blood Glucose

Measuring Device under current MEMSProtocol Standards.



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



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…



Altered Mental Status

(Common Causes)AEIOU-TIPS

Alcoholism Trauma

E pilepsy Infection

Insulin Psychiatric

Overdose Stroke

Underdose



Pre-Hospital Care

(FOLLOW THE PROTOCOLS)

1. Scene Safety/Survey

2. Perform initial assessment

Considering/Treating ABC’s

3. Ensure cervical spine immobilization as indicated

4. Activate ALS-ALS must be activated when using theglucometer.



Pre-Hospital Care

5. Perform focused history and physical exam

(a). SAMPLE history

1. Signs/Symptoms (when did they start?; how long didthey 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/Head/Spinal Injury.



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 intercepting ALS service/provider



Glucose Measuring Devices• Used to Check Blood Sugar Levels

• Many different types and models



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



Device & Accessories

Glucometer

Test Strips

Lancet



Glucose Measuring Steps

Step #1 Step

#2

Locate Glucometer

Open Up Case

Step #3

Turn Power On



Some glucometers turn on automatically.

Know the features of the glucometer your service uses.

Device Variations



Glucose Measuring Steps, cont.

Step #4

Confirm Codes




Step #5

Insert Test Strip




Step #6

Obtain Blood Sample



Apply Drop of Blood

If inadequate up to 15 secs., add additional blood

Step #7





Step #8

Document Results



Results

• Measured in milligrams per deciliter

• Normal blood glucose range is typically

80-120 mg/dl (fasting)

• Treat the patient, not the numbers



Maintenance & Calibration

• FOLLOW MANUFACTURER’SRECOMMENDATIONS:

•Techniques• Frequency

• Batteries

• Care & Storage

– Device – test strips

• Temperature Can Affect Machine Accuracy!!!!



Documentation

• Reasons for procedure

• Time of procedure

• Results of procedure

• Response to treatments

•Changes in signs/symptoms



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



CLIA WAIVERS

• Required for all services using a glucometer

• The Centers for Medicare & Medicaid Services

(CMS) regulates all laboratory testing (exceptresearch) 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.



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

http://www.cms.hhs.gov/clia/






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



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



Questions?

Documents

Gluco Meter Training Program