You know an emt is correctly using a glucometer when she performs which one of the following?

The level of glucose in the blood can be measured by applying a drop of blood to a chemically treated, disposable ‘test-strip’, which is then inserted into an electronic blood glucose meter. The reaction between the test strip and the blood is detected by the meter and displayed in units of mg/dL or mmol/L. There are a number of different types of meters available, and all are slightly different. Take care when applying the general principles described in this article to the specific glucose meter you are using.

Table of Contents Show

Why measure blood glucose?
Calibrating the blood glucose monitor

Why measure blood glucose?

It can be used as a screening tool for diabetes mellitus (diabetes).
It is an important tool in the assessment of the unwell patient, especially in the young or old.
Potentially life-threatening extremes of blood glucose can be detected to enable the patient, carer or health worker to respond to high (hyperglycaemia) and low (hypoglycaemia) blood glucose by adjusting the diet or using insulin.

Blood glucose should be measured whenever your patient with diabetes is feeling unwell in any way.
In the diabetic patient, it should be measured before surgery to ensure that the patient is not going be become unwell during surgery and/or after general anaesthetic. Measure regularly until the patient is eating and drinking normally and blood glucose is stable.
In newly diagnosed diabetes patients, more frequent measurements are needed, until blood glucose is stable.

Top tips

Patient safety and comfort

Be aware of what ‘normal’ blood glucose levels are. Find out what is ‘normal’ for individual patients by asking them and/or checking their notes or file.
Take universal precautions as blood is being handled.
Use aseptic techniques as the skin is being punctured. While it would be unusual for infection to occur, patients with diabetes tend to heal less well and may not deal as well with infection.
Invite the patient to do the procedure if they self-test regularly (provided they are familiar with the particular meter); they may well be better at it than the health worker. Take the opportunity to check the patient's technique.
Do take notice if the patient gives you ideas about where best to take blood from!

If you can't get blood from the finger prick

Ask the patient to hang the hand down below the waist for a minute or two.
Ask the patient to place the hands in or under warm water and rub them together.
Grasp the area to be pricked and squeeze gently for 3 seconds.
Place the finger on a table or other firm surface to avoid moving while pricking.
If the lancing device has a dial-a-depth facility, increase the setting by 1 level.

NOTE: Blood glucose monitoring is done to measure the concentration of glucose in the blood (glycaemia) over time, and is important in the care of patients with diabetes mellitus. Information about individual patterns of blood glucose changes, gathered through blood glucose monitoring, can be used to plan meals, activities, and at what time of day to take insulin. The better the patient's blood glucose control, the less likely it is that the diabetes will cause damage in the body and lead to complications such as loss of vision (due to diabetic retinopathy) and amputation.

Test strips (check that they are in date and have not been exposed to the air)
Single-use safety lancets or lancing device
Control solution for calibration

Apply these general principles when using the different types of electronic blood glucose meters available.

Ask the patient to sit down and explain what you are going to do.
Wash your hands and put on gloves.
Choose the site for the blood sample: usually the side of a finger, but the arm or thigh may be used (change the site used if frequent measurements are needed).
Use an alcohol swab to clean the site and let the alcohol dry.
Insert the test strip into the monitor, following the instructions (Figure 1).
Use a single-use lancet or a lancing device to draw blood (Figure 2) and dispose of it in a sharps container.
Apply the blood to the testing strip (Figure 3) in the correct way: some strips need the blood drop to be over the whole of the test pad and some suck up the blood directly from the site of the bleeding.
Place the alcohol swab (note: it will sting) ora piece of gauze over the site (Figure 4) and hold it there, or let the patient hold it there until the bleeding stops. Monitor for excess bleeding.
Read and record the result, reporting and/or responding to abnormal readings.
Tell the patient what the result is, explain it and discuss options.
Dispose of all used equipment safely, in line with hospital or health care policies.

Calibrating the blood glucose monitor

Calibrate the monitor and each new pack of test strips together.
Calibrate the monitor each week.
Place the control solution on a test strip and check that the value shown on the monitor matches the value on the bottle (or the pack of strips it accompanies). Record the calibration readings.
If one is provided, use the check strip to make sure that the meter is working.

Articles from Community Eye Health are provided here courtesy of International Centre for Eye Health

8) What is a glucometer used to evaluate?A) Glucose levelsB) Insulin levelsC) Glucogen levelsD) Insulin and glucose levelsAnswer:ADiff: 1Page Ref: 566Objective:20-1; 20-59) A glucometer reads 50 mg/dL. The EMT would recognize this as:A) high.B) normal.C) average.D) low.Answer:DDiff: 1Page Ref: 566Objective:20-5; 20-7

12) You are instructing EMT students on how to obtain a blood sample for use in a glucometer.You are providing accurate information by stating:A) “It is best to check the blood three times and then use the highest reading.”B) “Approximately 15 mL of blood will be needed for an accurate result.”C) “A small drop of blood obtained from the patient’s fingertip is sufficient.”D) “Have the patient raise his or her arm in the air prior to obtaining blood.”Answer:CDiff: 1Page Ref: 582Objective:20-541) You know an EMT is correctly using a glucometer when she performs which one of thefollowing?A) Avoids cleaning the finger with alcohol prior to pricking it with a lancetB) Wastes the first drop of blood obtained from the patient’s fingerC) Asks the patient to hold his hand above his head prior to pricking a finger for bloodD) Uses a lancet to prick an artery or vein for the blood sampleAnswer:BDiff: 2Page Ref: 567; 582Objective:20-558) A medical-grade glucometer is used to measure:A)insulin levels.B)glycogen levels.C)blood sugar levels.D)carbohydrate levels.Answer:CDiff:1Page Ref: 566Objective:20-5; 20-759) To decrease the possibility of a faulty glucometer reading, you would:A)use the first drop of blood obtained.B)use venous blood only for testing.

C)avoid the use of alcohol as an antiseptic.D)make sure test strips are in date.Answer:DDiff:2Page Ref: 566Objective:20-5; 20-761) A patient exhibits signs and symptoms of diabetes. However, he informs you that he has notbeen diagnosed with the disease. You decide to check his blood sugar. If the patient is a diabetic,which of the following readings would you expect?A)465 mg/dLB)110 mg/dLC)0 mg/dLD)70 mg/dLAnswer:ADiff:Page Ref: 567Objective:20-5; 20-69) A glucometer reads 50 mg/dL. The EMT would recognize this as:A) high.B) normal.C) average.D) low.Answer:DDiff: 1Page Ref: 566Objective:20-5; 20-710) For which patient would the EMT have the strongest suspicion of a diabetic emergency?A) Confused patient with a blood glucose of 58 mg/dLB) Alert and oriented diabetic patient with generalized weaknessC) Combative patient with a blood glucose level of 122 mg/dLD) Diabetic patient complaining of chest pain and shortness of breath