out of curiosity during my ride ons when i was in my basic class.(now a basic looking for a job) all the medics used venous blood after stick. i know the correct way is cap. blood if you will share what do u do? i will always use cap. blood. their excuse was we stuck them once why stick them again
Bgl
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DesertMedic66
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Already got blood from the IV flash. Why stick the patient again?
For us all patients who get an IV get the BGL tested. If they don't get an IV then BGL is done on suspected diabetic emergencies and/or patients with a diabetic history.
For us all patients who get an IV get the BGL tested. If they don't get an IV then BGL is done on suspected diabetic emergencies and/or patients with a diabetic history.
DrankTheKoolaid
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Its not a shortcut when the newer glucometers in use are rated for venous sampling and running ketones
socalmedic
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do you know the make and model of the glucometer? I can tell you that my glucometer is rated for venous and capillary blood. not only that but i can prick the patient anywhere not just the fingers.
the_negro_puppy
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Mostly just cap blood.....if i suspect a problem with BGL I'd probably be testing it before starting an IV then testing.
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What he said. It's not cheating. We do what's best for the patient and that doesn't include jabbing them with sharp objects repeatedly when you already have a sample you can use. Even if your glucometer isn't rated for venous samples the reading isn't going to be off by *that* much.
Only use fingersticks if we aren't starting a line or if we suspect the pt is having a diabetic problem when we arrive on scene.
Tommerag
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When I was in class and we were doing IV's on each other we would do both on the same person and never saw a reading off more then 10-15.
I read a study a while back about this. (I can't remember where so I can't link to it but, you may be able to find it). It says that venous blood is about 15 mg/dL lower than capillary blood. So as long as you take that into consideration when you test them then I see no reason why it would make a difference. If you need a really precise measurement though, I would go for capillary blood.
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we use the bayer contour which is good for venous blood
TyBigz
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Ive always seen it if they get a flash on the IV then they just use that. There is no need to prick the pt again and expose more blood.
kindofafireguy
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Actually, the capillary method is less accurate in critically ill patients.
See http://www.ncbi.nlm.nih.gov/pubmed/17763842. There are few other studies, but I'm too tired to post them. One deals with CPR, and shows it to also be inaccurate.
I can't remember the exact numbers, but it was something like 75% sensitive and somewhere around 40% specific for hypoglycemia.
The studies are probably outdated at this point, though. The glucometers are probably more accurate these days. I think that study I linked to is from like '07.
Further research on my part would require too much effort.
Moral of the story, though: Capillary isn't necessarily better, and venous isn't a "shortcut" or a lazy choice.
See http://www.ncbi.nlm.nih.gov/pubmed/17763842. There are few other studies, but I'm too tired to post them. One deals with CPR, and shows it to also be inaccurate.
I can't remember the exact numbers, but it was something like 75% sensitive and somewhere around 40% specific for hypoglycemia.
The studies are probably outdated at this point, though. The glucometers are probably more accurate these days. I think that study I linked to is from like '07.
Further research on my part would require too much effort.
Moral of the story, though: Capillary isn't necessarily better, and venous isn't a "shortcut" or a lazy choice.
CCNRMedic1982
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Had a pt. that I measured both on to prove a point to a student. Measured blood from the IV and blood from finger and there was an 8 point difference with cap blood being higher at the time. Pts venous reading was 54 and capillary was 62. Pt was diabetic with complaints of same. Did this for about a week with different pts. To see the difference and stayed about in the same range. Overall whenever pts BGL was critically low or showed some sign/symptom to support that finding whether using venous or cap blood. I use capillary blood now because it is easier than taking from IV sight, less messy, and our glucometer won't allow for it. Check your monitor and it should tell you. Everything isn't in your protocols.