1. Advanced Paramedic Skills

2. Blood Glucose Determination Glucometers –How they work Preparation of the patient –Consent –Anticipate patient changes Prepare the glucometer Take the blood sugar Record the reading

3. Presentation of the Diabetic Patient? Signs and Symptoms?? -

4. Consent – Needs to be Given prior to treatment Ability to appreciate…….what? Ability to understand……..what? See aid to capacity Informed via implied (implied is not just _____________)

5. Leaving a patient on scene

6. Glucometer-Ascentia Contour No coding 15 sec Touch strip to Blood drop See handout

7. Glucometers Various kinds Home glucometers Various components –Glucometer –Test strips –Hi/Low solutions –Lancet

8. Test strips Batch of them First, orientate the glucometer to Lot number, then use entire lot Once completed, sync glucometer to next lot number Work by capillary action so shouldn’t need a lot of blood Test hi and low at least once a week (Q&A) Machine itself records all glucometer readings in internal memory (for retrieval)

9. Procedure Tell patient what you are doing PPE Insert test strip into glucometer, it counts down to ‘rdy’ or ‘ready’. Place nearby Ideally select non-dominant hand Swab pinky or fleshy looking finger +/- hang hang down for a few secs Grip finger firmly Swab well with alcohol, let dry Poke with lancet, dispose immediately into sharps container

10. Procedure continued Drop blood onto end of test strip When it has enough blood it gives a series of dashes and counts down. Record reading Dispose of contaminated test strip Bandage patient Treat PRN

11. Blood Glucose Determination Lab work Heres where you get to try it on each other

12. Readings for You! Caroline’s Review Diabetes and S&S –29.2-29.21 Review Anaphylaxis S& S –30.2-30.12 Review bronchoconstriction- 26.27-26.32- 1184 Read Pharmacology section 8.38-8.57 and 434-448 Name a few things that could be confused with hypoglycemia! What would they present like??