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Fistula and BGL assessment

Discussion in 'EMS Talk' started by Seirende, Nov 19, 2016.

  1. Seirende

    Seirende Forum Lieutenant

    I had a call today that had a few complicating factors, but the one that really threw me was that the pt had a fistula, which we didn't discover until partway through the call. The chief complaint was hypoglycemia and we were getting obviously erroneous BGL readings. After we switched the the hand on the non-fistula side, we got good numbers.

    Obviously, not a problem to just switch sides, but I was surprised that the fistula seems to have thrown the assessment off in the first place. I get the problem with taking BP on that side, but the glucose level should be the same throughout the periphery, correct?

    Was this our equipment being wonky or am I misunderstanding how fistulas affect circulation.
  2. Remi

    Remi Forum Deputy Chief Premium Member

    A fistula is simply an anatomical "connection" where one doesn't normally exist. In the case of a dialysis patient, you are probably talking about an AV fistula. This is a surgical graft between an artery and a vein that can be accessed with the right training and equipment.

    I can't think of any reason why it would affect a capillary blood glucose result.
  3. E tank

    E tank Caution: Paralyzing Agent

    Some POCT devices are calibrated to different metrics for venous and arterial blood. Our I Stat asks for a blood source even for non blood gas tests. Makes me wonder if the OP's device read too much arterial vs capillary content...kind of a stretch but that could be a cause.
  4. Summit

    Summit Critical Crazy

    Yes but not enough to cause big time eyebrow raising that leads to internet questions...
    NomadicMedic likes this.

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