ALBANY, N.Y., July 20, 2005 – Basic emergency medical technicians in the state of New York will be allowed to perform additional diagnostic tests to provide more efficient pre-hospital patient care, as a result of a two-year study conducted by Bruce Ushkow, M.D., director of emergency medical services at Albany Medical Center and medical director of the Albany Fire and Emergency Medical Services (AFD).
The joint research effort between Albany Med and the AFD showed that basic emergency medical technicians (EMTs) are capable of safely and accurately performing blood glucose tests, formally referred to as glucometry, when responding to the scene of an emergency. Glucometry, which is performed by pricking the patient’s finger with a lancet in order to obtain a blood sample, is typically performed only by advanced life support (ALS) providers—paramedics—who are trained to administer more advanced medical care, but often arrive at the scene after basic EMTs.
“Glucometry results are helpful in determining if a patient is suffering from a serious sugar-related medical condition,” said Dr. Ushkow. “If the basic EMT is the first to arrive at a scene, allowing them to perform glucometry and act upon the results could improve accuracy of the diagnosis and expedite proper care.”
Ushkow further explains that if both the EMT and the paramedic arrive together, the task of determining the blood glucose can be shifted to the basic EMT, allowing the paramedic to better allocate his or her time to directing patient care activities or performing more complicated skills.
According to Ushkow, if a patient’s blood sugar is less than 80 mg, basic EMTs can administer orange juice or a glucose paste. If the blood sugar is over 400 mg, advanced medical care is necessary.
For the study, the AFD trained 111 basic EMTs to perform glucometry. Pretests and post-tests were given to evaluate skill retention. Of nearly 800 independent uses of the glucometers by basic EMTs over a six-month period, no blood borne pathogen exposures or sharps injuries occurred. Nearly 17 percent of patients treated were found to have dangerous blood sugar levels. In some cases a dangerous sugar level was detected but initial dispatch information did not reveal the need for a paramedic. By having this diagnostic tool available, basic EMTs appropriately summoned the paramedics, who were able to administer intravenous sugar or an intramuscular medication called glucagon.
The New York State Department of Health has approved the additional basic EMT training and has directed Ushkow to develop a training program that can be used by other regional EMS agencies within New York State, and possibly used as a model in other states as an optional component to basic EMT training.
The Albany Fire Department covers more than 21 square miles of urban and suburban environment. The department responds to 19,000 calls a year and is staffed by 260 emergency medical services providers, including 70 paramedics.
Albany Med’s emergency department is the only Level 1 state-designated trauma center in the region, able to treat the most serious illnesses and injuries.
Albany Medical Center is northeastern New York’s only academic health sciences center. It consists of one of the nation’s oldest medical schools, Albany Medical College;
one of New York’s largest teaching hospitals, Albany Medical Center Hospital; and one of the Capital Region’s most active fund-raising organizations, the Albany Medical Center Foundation, Inc.
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