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Phlebotomist scope of practice question


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The scope of practice varies according to each state. As an ASCP trained phlebotomist (which is national) we did review point of care testing, however, we were never trained or tested on how to administer administer IM, SubQ or IV medications or vaccinations.

 

Often times, medical assistants will double cert to include phlebotomy and they will do both blood draws and administer injections.

 

The scope of practice that I am aware of limits phlebotomist to collecting blood and urine specimens specifically for lab testing, POCT, or therapeutic phlebotomy.

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Thank you Timon.

 

I have an additional question. Let's assume I am not a PA, RN, or LVN and only a CNA and home health aide provider (in CA)...and my patient did not take his/her insulin and now has very high blood sugar level. This is obviously concerns me, so would I be in the wrong if I gave my patient the insulin shot? In what scenario would it be okay for me to administer a shot- only in emergency situations?

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As a regular CNA without any other credential, I'm going to tell you that in California you are most likely not allowed to administer insulin injections. 

 

I believe as a CNA you have to register as Insulin Administration Certified. I don't know the requirements for that.

 

Here is a link to the FAQs for CNAs regarding insulin.

http://health.mo.gov/safety/cnaregistry/faqs.php#gen3

 

Further, as an EMT-B working as an ER Tech in California, we are not allowed to administer any injectable medications. 

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you can help the pt give themselves a shot (get the stuff for them and hand it to them to prepare and give). if they can't you probably need to call 911...if they never give their own shots you need to find a nurse or someone who can.

phlebotomy by itself is not a terribly wide scope of practice. it is a skill learned by many other providers in the course of their training. for me as an er tech in the 80s it was draw blood ten times in the presence of an RN and they sign you off, you send the info to the state, and they send you a cert. took me less than a week in addition to getting certed to give IM and subq injections.

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Please do not call 911 just because their sugar is high. If the patient is experiencing symptoms that warrant an emergency transport to the ER, then by all means, please call 911. Otherwise, a family member or friend should drive the patient to their PCP (or ER as a last resort). We should be encouraging patients and their families to they providers appropriately, and steer them away from the ever growing culture where calling 911 for everything seems acceptable.

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Please do not call 911 just because their sugar is high. If the patient is experiencing symptoms that warrant an emergency transport to the ER, then by all means, please call 911. Otherwise, a family member or friend should drive the patient to their PCP (or ER as a last resort). We should be encouraging patients and their families to they providers appropriately, and steer them away from the ever growing culture where calling 911 for everything seems acceptable.

I was responding to the post that said "nursing home pt with a cbg that was VERY HIGH".  Very high to me means > 400. in a debilitated nursing home pt that should prompt at the very least an urgent pcp appt (like within a few hrs) or an er visit. we don't know in this hypothetical if this ill nursing home pt is in dka, septic, etc.

sure, if it's 255 I could care less. I work in the er a place known for "r/o worst case scenario".

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