Blood glucose question...

[EMT-IT753]

How many people still use an alcohol wipe when checking sugar on a clean finger?

In one of the systems I work for, we do not use an alcohol wipe unless the finger is soiled. In another system I work for they insist on using the alchohol wipe?

I am curious to see if people are still using this technique.

 

[MrBrown]

No, and we also do not use the needle from an IV cannulae to do a BGL

BTW WTF is an EMT-IT

 

[TransportJockey]

Some people who work in my system do, but I do not after having worked in a hospital. alcohol preps can give you a false high reading.

Brown, why not flash chamber blood for a BGL reading? I can't remember exactly, but from my reading it only is a few points off from a CBG.

And I'm guessing IT might be IV Tech? But I don't know. There are too damned many retarded EMS levels in the US

 

[EMT-IT753]

EMT-IT is an EMT-Intermediate Technician here in Wisconsin. It is a little higher than an EMT-B and a long ways below an EMT-P

The main difference between the B and IT is we are IV trained and have D50 and Narcan thrown into our list of approved meds we can administer. In my area we also are trained in phlebotomy. The IT curriculum goes a little deeper into assessments as well. Other than that, we are glorified EMT-B's.

I went rounds with one of my team members this morning at 0330 about me not using an alcohol wipe. He insisted I was dead wrong, but whatever, we just agreed to disagree.

Thanks for the input B)

 

[reaper]

Unless you have super vision. Learn to use them on all BGLs.

I don't know how many times I get people not cleaning a finger and getting high readings. If pt has sugar on finger, it will mix with blood and give false readings.

You are dealing with diabetics. Antiseptic cleansing is very important.

Alcohol will only give high readings, if you do not allow it time to evaporate.

Had a AMS the other day. Partner checked BGL without a wipe and without telling me. BGL was 187. I just happen to take another BGL off IV cannula and it was 22. Recheck on finger, after wiping was 26. This is why you clean them.

 

[DFW333]

Theres several systems in North Texas that have actually started the trend of removing BGL checks from EMT-B skill set altogether. They are getting false readings left and right, some were checking D-sticks 2x per transport on all patients regardless of chief complaint, some were not checking it on AMS patients and a few somehow managed to stick themselves.

Of course, in their infinite wisdom these companies still allow basics to give oral glucose to the AMS pt who has low sugar... :wacko:

 

[Sasha]

Of course they move to taking away the option of taking a BGL instead of spending a little time on properly educating them when, how, and why to check a glucose.

 

[jjesusfreak01]

Of course they move to taking away the option of taking a BGL instead of spending a little time on properly educating them when, how, and why to check a glucose.

Which is ridiculous considering its one of the more common calls in EMS that occasionally basics will need to handle themselves.

 

[Lola99]

In Indiana, basics don't anyway. "Too invasive" ...:blink:

 

[jjesusfreak01]

In Indiana, basics don't anyway. "Too invasive" ...:blink:

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.

 

[Lola99]

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.

Ha. No kidding. Hellooo, band-aid box...

 

[mikie]

Are regular glucometers calibrated to read venous blood?

(For those who draw it from the IV chamber? Obviously there wouldn't/shouldn't be a huge difference or anything, just curious)

 

[DFW333]

Are regular glucometers calibrated to read venous blood?

(For those who draw it from the IV chamber? Obviously there wouldn't/shouldn't be a huge difference or anything, just curious)

The service I work for uses glucometers that are calibrated for it. It seems logical to bring patients into the hospital with as few holes poked in them as possible.

 

[jjesusfreak01]

The service I work for uses glucometers that are calibrated for it. It seems logical to bring patients into the hospital with as few holes poked in them as possible.

Do they actually need to be calibrated for that, or is it just a different scale? You wouldn't be getting a CBG reading, but thats just because you aren't taking capillary blood.

 

[DFW333]

Do they actually need to be calibrated for that, or is it just a different scale? You wouldn't be getting a CBG reading, but thats just because you aren't taking capillary blood.

I really dont know. The only difference I notice is when we use it on a finger stick the timer on the meter counts down from five. When we get blood from an IV catheter it counts down from fifteen. How it knows the difference is beyond my paygrade. When we first acquired these meters we did double check with finger sticks on more than 50 patients with an average error of +/-5 points on the reading.

 

[Phlipper]

Interesting read. I have wondered about this myself when I see EMT-Bs and Ps grab the blood sample when I can see over their shoulder the blood is diluting with the alcohol. Always wondered how that might affect the reading. So i started wiping, then blotting with the gauze before sticking. But that's just me. It prolly doesn't make enough difference in the reading.

 

[TransportJockey]

Interesting read. I have wondered about this myself when I see EMT-Bs and Ps grab the blood sample when I can see over their shoulder the blood is diluting with the alcohol. Always wondered how that might affect the reading. So i started wiping, then blotting with the gauze before sticking. But that's just me. It prolly doesn't make enough difference in the reading.

From what I was taught is you wipe away the first bit of blood anyways, so doing that sounds right

 

[DFW333]

From what I was taught is you wipe away the first bit of blood anyways, so doing that sounds right

The problem with wiping away the first bit of blood is you sometimes (albeit very rarely) get a person that doesnt bleed very much. You wipe away the first bit of blood and you dont get enough after that to get a reading.

 

[emt_irl]

my company made an s.o.p that we must wipe finger clean before using lancet, but give it a few seconds to dry before we take sample of blood.

being entirley honest i dont see why in most cases? unless the finger tip is soiled.
My mother has been a diabetic all her life and i have been surround by the medications, bgl checks etc for as long as i remember and ive never seen a noticeable different between a wiped and un-wiped finger, using her as a control.

 

[DFW333]

my company made an s.o.p that we must wipe finger clean before using lancet, but give it a few seconds to dry before we take sample of blood.

being entirley honest i dont see why in most cases? unless the finger tip is soiled.
My mother has been a diabetic all her life and i have been surround by the medications, bgl checks etc for as long as i remember and ive never seen a noticeable different between a wiped and un-wiped finger, using her as a control.

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.