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Glucometer

Indications: Altered mental status and/or neurological dysfunction,  or known diabetic with confusion, weakness, tachycardia, or flushing    

Contraindications: Possible skin infection present at sample site

 

Equipment: FDA approved glucometer, cleansing wipes (alcohol swab), sterile 2x2 or 4x4, sterile lancets, small clean or sterile bandage/bandaid, sharps container

 

Procedure: Appropriate PPE

  • Prepare sample site (side of fingertip pad or lateral side of infant heel) w/ appropriate cleansing wipe and allow to air dry

  • Remove test strip and insert in glucometer, assure code on glucometer LED screen matches test strip vial

  • Grasp finger near prepared site, keeping site below level of heart if possible.  Use lancet to quickly prick side of finger or infant heel until a drop of blood is formed.  Wipe away 1st drop of blood w/ gauze and allow site to form 2nd blood drop.

  • Place 2nd drop of blood onto test strip in glucometer and cover pt sample site with bandage.

  • Record and document blood glucose value when displayed.  Dispose of lancet in approved sharps container.

 

Documentation: time blood glucose value was obtained and actual blood glucose value

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ORAL GLUCOSE

Indications: Altered mental status or neurological deficiency and one of both of the following: 

  1. Hx of diabetes and taking insulin or oral diabetes medication and/or 

  2. Glucometer reading below 80 mg/dl and ALS present or enroute.  Pt must have ability to swallow and an intact gag reflex.

Contraindications (Do Not Give): Unresponsive pt, cannot swallow or has no gag reflex

 

Procedure: Ensure ALS unit is enroute

  • Assure pt is responsive, has intact gag reflex and ability to swallow and protect their own airway

  • Assure med is “glucose for oral administration” and has not expired

  • Administer medication

  • GEL or PASTE – squeeze small portions of  gel/paste into pts mouth between cheek and gum on each side until tube is empty or apply oral gel to 1-2 tongue depressors and place between cheek and gum, one on each side of pt’s mouth, w/ medication side contacting pts cheek

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