Blood Glucose Measuring Devices Blood Glucose Measuring Devices in the Pre-hospital Settingin the Pre-hospital Setting

Indications for BG Measuring

Signs and Symptoms consistent with Acute Stroke Altered Mental Status

Hypoglycemia Blood glucose level of 80 or less Most calls for diabetic emergency Signs and symptoms:

Hunger Nervousness or shakiness Perspiration Dizziness or light-headedness Sleepiness or weakness Confusion Difficulty speaking Unresponsiveness

Hyperglycemia

Blood glucose level of 120 or higher Most common but least calls to EMS Signs and symptoms:

Frequent urination Increased thirst

May lead to Ketoacidosis

Procedures Careful attention to BSI & safety Insert Glucometer test strip into device Select Finger Massage blood into distal end Clean finger with alcohol & allow to dry Use lancet or Auto-lancet device Wipe first drop of blood off Apply drop of blood onto test strip and follow

individual glucometer instructions Dispose of sharps and soiled supplies

Step 1

Step 2 Get out a lancet (prepare the lancet as needed) Locate the place for the finger-stick: Choose a finger… any finger (usually not the

thumb) Use the side of the pad of the finger, between

the knuckle and the finger tip

If the patient has callused fingers or thick skin it maybe difficult to get blood, try to find a place with “thinner” skin

As EMT providers we are not authorized to use alternate site testing (IV starts, toes, arms, etc.) if fingers are not available, medical control must be contacted for orders to test an alternate site

Step 3 Clean the finger tip that you will be

performing the finger-stick on with an alcohol prep pad

Be sure the area dries completely, use a sterile gauze pad to dry the area if needed

Note: un-dried alcohol may skew the reading so make sure it dries completely

Step 4 Lance the finger with the lancet Lower the hand and squeeze the finger

gently (if needed) to assist with producing a small droplet of blood

Step 5

Step 6

When the blood glucose reading appears, document it immediately on the ePCR

Ex: “blood glucose 100 at 13:57” Continue to treat the patient per Maryland

Medical Protocol

Troubleshooting What could go wrong when using the glucometer?

Dead batteries Always carry spare batteries in the ambulance and

check the unit regularly “Error” reading appears Insert a new strip, re-test, check batteries Unable to get enough blood from finger-stick Lance a different finger, if skin is cold-try warming with

a hot pack wrapped in a towel Inaccurate reading Why do you think it was inaccurate? Was the alcohol

dried? Was the strip contaminated? Try re-testing.

Results Normal blood glucose range is typically

If it reads “LO” = lower than 20 mg/dl

If it reads “HI” = higher than 500 mg/dl

If it reads “E-3” = may be too low to read

If it reads “E-4” = may be too high to read

Any of these readings could also indicate that there is a problem with the test strip. Remember to treat the patient and not the number on the meter.

80-120

Maintenance & Calibration

Techniques Frequency Batteries Care & Storage

DeviceTest strips

Documentation