Strote Jared, Cloyd Donald, Rea Thomas, Eisenberg Mickey
Division of Emergency Medicine, University of Washington Medical Center, Seattle 98195, USA.
Prehosp Emerg Care. 2005 Jul-Sep;9(3):318-21. doi: 10.1080/10903120590961987.
Rapid glucose testing is a valuable tool for emergency medical services (EMS) patient evaluation and treatment. In most EMS systems, paramedics, but not emergency medical technicians (EMTs), are authorized to use glucometry.
To evaluate the influence of EMT glucometry on paramedic involvement in a two-tiered EMS response system.
King County, Washington, EMTs underwent training in glucometry to determine blood sugar levels for specific patient presentations. The authors conducted a prospective cohort study of the first 500 EMT uses of glucometry, from October 2003 through March 2004, during which time EMTs recorded their subjective assessments of this additional information on their decisions to involve paramedics.
Overall, glucometry results appeared to influence EMT decisions to involve paramedics. Glucometry prompted EMTs to upgrade the triage level and request paramedic evaluation for 5% of patients (n = 22); glucometry caused EMTs to downgrade the triage level, canceling already dispatched paramedics for 5% of patients (n = 23); and glucometry allowed EMTs to function without paramedics when they otherwise would have called for assistance for 11% of patients (n = 52). In an additional 12% of patients (n = 54), paramedic involvement was not actually influenced, but EMTs still indicated that glucometry would have had an effect on triage had paramedics not been present.
Use of glucometry by EMTs appears to influence the decision to involve paramedics, potentially enabling more efficient and appropriate triage.
快速血糖检测是紧急医疗服务（EMS）中用于患者评估和治疗的一项重要工具。在大多数EMS系统中，护理人员被授权使用血糖仪进行血糖检测，而急救医疗技术员（EMT）则无此权限。
评估急救医疗技术员进行血糖检测对护理人员参与两级EMS响应系统的影响。
华盛顿州金县的急救医疗技术员接受了血糖检测培训，以便为特定患者情况测定血糖水平。作者对2003年10月至2004年3月期间急救医疗技术员首次使用血糖仪的前500例情况进行了前瞻性队列研究，在此期间，急救医疗技术员记录了他们对这些额外信息如何影响其呼叫护理人员决策的主观评估。
总体而言，血糖检测结果似乎影响了急救医疗技术员呼叫护理人员的决策。血糖检测促使急救医疗技术员将5%的患者（n = 22）的分诊级别提高并请求护理人员进行评估；血糖检测使急救医疗技术员将5%的患者（n = 23）的分诊级别降低，取消已派出的护理人员；血糖检测使11%的患者（n = 52）在原本会呼叫帮助的情况下无需护理人员参与即可处理。在另外12%的患者（n = 54）中，护理人员的参与实际上未受影响，但急救医疗技术员仍表示若没有护理人员在场，血糖检测会对分诊产生影响。
急救医疗技术员使用血糖仪似乎会影响呼叫护理人员的决策，可能使分诊更高效、更恰当。
