One of the easiest ALS tools to use, but often one of the most neglected, is the glucometer. Gone are the days of putting drops of blood on a chemical test strip and staring at it intently, trying to figure out which color it had changed to. Today’s provider has accurate test results in as little as five seconds. But three challenges are commonly faced by the ALS provider using a glucometer:

» Not using the glucometer on the correct type of patient;
» Poor use and maintenance of the glucometer;
» Inaccurate readings.

Too often we think of using the glucometer only on those patients in whom we elicit histories of diabetes or who present with the common initial findings of hypoglycemia (confusion/unconsciousness, diaphoresis, medical alert bracelets, etc.). The reality is that the glucometer can provide a quick check of any patient with an altered level of consciousness, unexplained fall or lethargy. As with many medical conditions, signs and symptoms can be indicative of more than one thing; hyper- and hypoglycemia are not limited to those who suffer from diabetes. I have yet to meet an experienced ALS provider who has not been fooled by this at some point in their career.

According to the FDA, there are currently more than 25 approved portable glucose testing devices available. Although these may have different buttons or steps to take, the procedure for using them is roughly the same.

1. Prepare your equipment and, when possible, explain the procedure to the patient and gain consent for the test.
2. Cleanse the site of the puncture to obtain your blood sample.
3. Next, obtain a drop of blood (glucometers use minute amounts of blood for the test, measured in microliters) and apply it to the test strip. Some machines require the blood to be applied to the test strip before it’s inserted into the device, while others have the test strip inserted first (which generally turns the machine on) and the blood then applied to the end. The machine will begin analyzing the sample while you apply a sterile adhesive bandage to the site (as it is a potential site of infection).
4. Properly dispose of your supplies, and continue your treatment and assessment of the patient.

From EMSResponder.com

Filed under: EMS, Proper Practices