IV Catheter -v- Finger Stick Blood Glucose

[mikeymedic1984]

Actually there are several reasons why you can get a false high or low from a glucometer (metabolic conditions, improper cleaning of site, glucometer out of calibration or stored in too hot or cold of a climate), so as stated above, you should be treating the patient, not the machine. The doctor you referenced probably orders $1,000.00 worth of lab tests on a flu patient. Nonetheless, I am more concerned about you handling the contaminated needle to get your sample, rather than doing a finger-stick. Do you not see the inherent danger in doing so ? Yes, you are saving the patient a "stick", but by what percentage have you increased your chances of getting a stick ?

[scubanurse]

How would he be handling the contaminated needle? Start the line, remove and safety the needle, put test strip under hub, release a little pressure and get your drop of blood.

[Just Plain Ruff]

Actually there are several reasons why you can get a false high or low from a glucometer (metabolic conditions, improper cleaning of site, glucometer out of calibration or stored in too hot or cold of a climate), so as stated above, you should be treating the patient, not the machine. The doctor you referenced probably orders $1,000.00 worth of lab tests on a flu patient. Nonetheless, I am more concerned about you handling the contaminated needle to get your sample, rather than doing a finger-stick. Do you not see the inherent danger in doing so ? Yes, you are saving the patient a "stick", but by what percentage have you increased your chances of getting a stick ?

your service isn't still using the needles that aren't safety needles are you?

[jwiley40]

I hate to say it, but no we're not. Money saving venture by our administrator. She did splurge for Autopulses and new powered cots and the Zoll E Series monitors (which I'm not too fond of) but we still have the nonsafety needles. A friend of mine here got stuck by a catheter that was somehow jabbed into the bottom of the monitor case. When he went to move it, he got stabbed. No one really knows where the catheter came from, but it still had the catheter over the needle. Still had to go through the needle stick protocols though. He ain't too happy about it. Now he works move for a service that has safety catheters.

[ERDoc]

That sucks for your friend. At least he saw the light and left. Those non-safety needles should not be allowed to be used anymore. I'm surprised OSHA or JHACO (not that they have say over EMS) haven't jumped on this yet.

[Just Plain Ruff]

If any service tells you that they are using the old non-safety needles as a cost saving mechanism they are full of shit. The cost savings from one infection from a needlestick that could have been prevented by using a safety needle would more than offset the savings they are getting from using non-safety needles.

And if one of their employees needs a liver transplant due to hepatitis C infection or long term antibiotic care, the cost savings don't even compare.

[ERDoc]

Stop thinking logically Ruff, we're talking about management here.

[jwiley40]

Captain, your preaching to the choir! Unfortunately, I'm a minion. I have a policy since I started as a medic student: keep your sharps in front of you at all times. Second policy: announce to your partner, whether stationary or not, "I have a sharps out!" I found by doing this, it makes my partner drive better and more steady on these horrendous Missouri roads!

I have another question that somewhat follows this thread. I treated a pedi with hypoglycemia. Pt is 7months old, male. Blood glucose, WITH LANCET, was 38mg/dl with pt reacting with Mom. I have been tearing up the internet trying to find the normal range of blood glucose for a pedi under 12months old. I have come up with everything from 30-110mg/dl to 40-170mg/dl. One of them was from mayocliniconline.com. The one that makes the most sense is from the University of Iowa Health Care that gives range of 65-99mg/dl, defining it as 1 month to adult. It's more along the range of what we normally see.

Needless to say, my little guy was sent to higher level of care because his bgl never got above 74mg/dl and he was acting normally, according to Mom.

[island emt]

I can't believe any service is still using non safed sharps.

Engineered controls are required by OSHA or Dept of labor where ever possible.

OSHA 29cfr10 covers this aspect.

I haven't seen an old catheter in over 15 years on any of the 3 services I've worked at in that time.

If I was that medic that got stabbed , there would be a lawsuit for not providing those engineered safety controls on equipment in favor of saving a few cents per catheter.

Do you work for the empire by chance????

[Just Plain Ruff]

I can't believe any service is still using non safed sharps.

Engineered controls are required by OSHA or Dept of labor where ever possible.

OSHA 29cfr10 covers this aspect.

I haven't seen an old catheter in over 15 years on any of the 3 services I've worked at in that time.

If I was that medic that got stabbed , there would be a lawsuit for not providing those engineered safety controls on equipment in favor of saving a few cents per catheter.

Do you work for the empire by chance????

Well in Dixon Mo there might be more than one Empire in play Island.