Mike McEvoy, EMS Coordinator

Saratoga County

33 Anchor Drive · Waterford, NY 12188-1148

 

 

 

 

December 10, 2001

 

 

 

Mr. Edward G. Wronski, Director

NYS Department of Health

Bureau of Emergency Medical Services

433 River Street, Suite 303

Troy, NY 12180-2299

 

 

Dear Ed:

 

I am writing to request clarification from the Department on an issue that affects the BLS services in my County.  As you know, the DOH Clinical Lab Evaluation Program at Wadsworth Center has issued several EMS provider agencies in Saratoga County CLIA numbers for performance of laboratory testing.  Issuance of CLIA registration requires the agency to have a physician medical director who assumes responsibility for testing, personnel training and competency, and continued quality assurance monitoring.  The question I would like addressed by the Bureau involves the skills being practiced by the EMS providers.

 

I would like to know if a finger-stick for the purpose of blood glucose determination is within the scope of practice of the EMT-B.  I believe there are two questions at the BLS level:

  1. In the situation where a BLS unit is attending a known diabetic who has a personally owned glucometer, can an EMT-B assist a patient in performing a fingerstick for the purpose of determining blood glucose using the patient’s own equipment? 
  2. In any situation involving equipment owned and operated by a BLS unit where blood glucose determination may be appropriate, is it within the scope of practice of an EMT-B to perform a finger stick for the purpose of blood glucose determination? Clearly use of a glucometer carried by a BLS unit and operated under a CLIA registration would be preferable to use of a patient’s own glucometer.  EMS providers can be fairly certain that a CLIA registered program glucometer will yield accurate results.  There is no assurance that medical testing devices owned or operated by a patient are accurate whatsoever.

 

Please note that I am not concerned with the reasons why an EMT may wish to determine blood glucose, or what actions they might take based on the information they obtain from their CLIA registered laboratory, only the actual skill being practiced by the EMT-Basic on the patient.

 

Thank you for your assistance in clarifying this practice issue.  I appreciate your continued support of EMS in New York State.

 

Sincerely,

Mike McEvoy