Yes Med. Dir. or No Med. Dir. Uuh! What?

[The Snake Man]

Get a load of this; we just recieved our new emt basic protocols. They state that we now have to call medical direction for oral glucose but we don't have to call medical directions to push Dextrose 50. Can anyone share with me why they think they have done this to us. Doesn't it seem a little rediculus or is there something Im missing or forgetting to think about.

Confused,

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The Snake Man!
Keep it above the water line! :)

[BURNSEMS]

It may be due to the ever slight possibility of Airway Comprimise in less than Concious Patient WHO KNOWS,,, HOWEVER,, Ask your Doc about how he feels about the RECTAL direction which is faster anyways.....which do you prefer??!!!!!

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Here today for a Safer Tomorrow

[Phil4601]

Well, I'd have to agree with BURNS when it comes to the question of a comprimised airway, though it would be my feeling that a properly trained individual should be able to recognise that and correct it. After all "A" is the first item in the primary survey.
As far as the administration of IV D50. Studies have shown that this intervention should only be carried out after further investigation and not be part of the standard protocol for the unconc. person.
A reliable history of diabetes is helpful, even more so is the reading you may get from a dextrose stick or accu check. In the case of confirmed hypoglycemia, by all means give the D50. But...if the change in the level of conc. is due to stroke or cerebral hemorrhage the D50 can cause more harm than good by changing the osmotic graident and actually increasing the incidence of increased intracrainal edema.
I guess what I'm trying to say is if you have any questions on what action to take, cover your butt and contact the medical command physician.