Blood glucose question...

[Akulahawk]

I've used blood samples from the IV cath many times. The glucometers were calibrated for venous blood though. When using the ones calibrated only for capillary blood, I've used venous blood, but as a gross check - as in grossly high or grossly low. If something's not right, or if I suspect right off the bat that I'd need an accurate FSBG check with a capillary blood only unit, I'll do a dedicated stick for capillary blood.

In either case, I'm going to ensure that the site is clean and dry after properly swabbing the site with the alcohol pad.

 

[Phlipper]

I've used blood samples from the IV cath many times. The glucometers were calibrated for venous blood though. When using the ones calibrated only for capillary blood, I've used venous blood, but as a gross check - as in grossly high or grossly low. If something's not right, or if I suspect right off the bat that I'd need an accurate FSBG check with a capillary blood only unit, I'll do a dedicated stick for capillary blood.

One of our medics showed me that trick just this week. Pretty cool. One less hole in a pt, and since we're initially looking for gross score anyway, it made sense. Lotsa good info here.

 

[emt_irl]

I think the books were written with the understanding that the person has such poor control over their diet that you'd be fetching their hand out of a bag of powdered donuts immediately prior to checking the BGL.

in my experence thats the exception not the rule though. most of my glycemic emergencies i come across are hypo though, who usually havent seen anything resembling food for hours at least.

 

[Akulahawk]

One of our medics showed me that trick just this week. Pretty cool. One less hole in a pt, and since we're initially looking for gross score anyway, it made sense. Lotsa good info here.

Since most of the BGL units I've worked with were able to use venous or capillary blood, I normally didn't worry about it. Why? The unit will tell me what the BGL is after making the appropriate adjustments via it's own software. With those units, I get to know what the blood glucose level is fairly precisely, so I don't have to do grossly low/high screening. I know.

In any event, if you have a BGL machine that can use venous samples, it's a nicer thing to check the BGL when you're doing an IV as you're only having to cause the patient pain once versus twice. Sometimes though, that's unavoidable. Someone who is hypoglycemic will have to be stuck a few times during the course of their care with me so that I can re-evaluate my Tx plan and make changes to it and/or intervene if necessary.

 

[PeteBlair]

I use an alchohol wipe followed by wiping with 2X2 - making sure the stick area is dry before sticking.

I've got another question (or two).

Do you carry your own BGL meter or does it belong to the vehicle (with other EMTs using the strips also)?

Do you often have to throw a bunch of strips away because they are out of date?

 

[TransportJockey]

I use an alchohol wipe followed by wiping with 2X2 - making sure the stick area is dry before sticking.

I've got another question (or two).

Do you carry your own BGL meter or does it belong to the vehicle (with other EMTs using the strips also)?

Do you often have to throw a bunch of strips away because they are out of date?

Each truck has one as does each jump bag in the trucks. We usually use the strips too fast for them to expire

 

[Shishkabob]

I use an alchohol wipe followed by wiping with 2X2 - making sure the stick area is dry

Hopefully a sterile 2x2? Otherwise you just defeated the whole purpose of the wipe...

 

[jjesusfreak01]

Each truck has one as does each jump bag in the trucks. We usually use the strips too fast for them to expire

Firefighters around here love to take blood glucose, because its like one of three things they can do as EMT/firefighters. When we get on scene where fire has been there for a few minutes, we get pulse, bp, bgl, spo2, and usually as much medical history and demographics as they can get. Its actually quite helpful now that I think about it.

 

[firemedic07]

if we give them an IV then we always check the sugar, its easier and quite less painfull to use the IV cath.

 

[llavero]

We do not use an alcohol wipe when checking sugar on a clean finger, and we carry our own BGL meter, but sometimes the ambulances have one.

 

[emt_irl]

I use an alchohol wipe followed by wiping with 2X2 - making sure the stick area is dry before sticking.

I've got another question (or two).

Do you carry your own BGL meter or does it belong to the vehicle (with other EMTs using the strips also)?

Do you often have to throw a bunch of strips away because they are out of date?

our ambulance has its own, as does each medication bag with lancets and test strips..

i use my own jump bag on calls and standby events and re stock from the ambulance, so i carry my own glucose meter, lancets and strips. i keep it qc'd along with the other units and throw away more strips then i use due to expiration dates etc....

 

[dudemanguy]

Just out of curiousity, when they say not letting the alcohol evaporate completely before taking a sample can give you a high reading, how much of a difference are we talking?

 

[reaper]

Easily 150 dl/ml difference!

 

[mikie]

question

what's your technique(s) for using the venous blood from the cath. or tubing or what? i've never actually seen it done but hear about it frequently...

(and it is kinda the purpose of this thread)

thanks

 

[TransportJockey]

what's your technique(s) for using the venous blood from the cath. or tubing or what? i've never actually seen it done but hear about it frequently...

(and it is kinda the purpose of this thread)

thanks

Since my service uses a safety cath that I hate, I get the glucometer ready and use a little bit of blood from the hub of the catheter once I pull the needle out

 

[JohnsFutureWife]

I always use alcohol wipes before doing a BGL.

 

[yotam]

Always use the wipes...

I guess more of a "if it's not broken don't fix it" sorta way (meaning it can't compromise the precision of the test then why not). I've also learned that alcohol dilates the blood vessel hence enabling stronger flow. Haven't really looked into it though...

 

[mc400]

You use a pen to poke the cotton part on the back of the safety cath and push out blood onto the test strip.

 

[jakeparamedic]

Always, Always, use alcohol wipes, of course give it some time to dry, but I've seen it so many times going on diabetic calls, the EMT-B's get excited and take the sugar without wiping off the individuals finger and it reads 200... because that person just ate an apple. Make sure you always use a wipe, give it some time to dry, then read the BGL.

 

[jakeparamedic]

Well, they better take Epi-Pens out of the scope too, since they're slightly more invasive...and painful. Sure, some people in BLS only regions may die, but its for the greater good.

Well maybe they should if they can't take a proper BGL.