[brutuss7]

We instituted an insulin protocol recently and have found that the finger sticks for blood glucose are destroying the patient's fingers. Any suggestions re products that due less damage to the fingers, other protocols for obtaining blood, etc., would be appreciated.

[RN34TX]

Your patient needs an A-line.
That's what we do for those patients on that insulin protocol.

[sirI]

Originally Posted by brutuss7

We instituted an insulin protocol recently and have found that the finger sticks for blood glucose are destroying the patient's fingers. Any suggestions re products that due less damage to the fingers, other protocols for obtaining blood, etc., would be appreciated.

Hello, brutuss7,

Could you utilize the alternative site testing glucometers???

[brutuss7]

Originally Posted by siri

Hello, brutuss7,

Could you utilize the alternative site testing glucometers???

What exactly is this?

[sirI]

Originally Posted by brutuss7

What exactly is this?

Hello again,

Many glucometers can accomodate the alternative testing site. Anterior forearm, for example. This saves the fingers. Many individuals use these for private use. Maybe you can approach your institution about this.

PM me for brand names if you are interested.

[papawjohn]

Hey Y'all

I run a lot of insulin gtt's. I don't see the need for q30m accuchecks. We do them q1h. You might start by seeing whether your protocol isn't faulty. Ours usually have changes in the rate of the insulin gtt in 0.5 unit/hr increments so changes tend to be gradual.

So if we can assume (we all know what happens when you 'ass-u-me', right?)
that you're doing 24 finger sticks/day and assume that the Pt has all his fingers--we are only sticking each finger 2 1/2 times per day. Now fingers have two sides and a middle. So if the Pt's fingers are getting punctured like they were hit by bird-shot--look for the other fingers or other sides of fingers that are not getting stuck. I almost guarantee that if you turn the hand over and look at the posterior (the 'trailing') side of his fingers, you find virgin territory. (WHOOPS--do I get penalty points for saying 'v####n' <grin>?)

I looked into the question of 'alternative' glucometers. As you might expect, it's an administrative nightmare. The Lab people have to certify our AccuCheks so the Lab-Nursing Committee has to get involved. There are MDs on these committees and they NEVER have strong opinions on anything do they? Then the Policy and Procedure people get involved because there is a difference in the cost of the two procedures....so how do you decide who gets the 'old' and who the 'alternative' glucometer. The Supply people have to decide which one to buy....I could go on and on.

What a way to run a railroad, eh?

Papaw John

[sharann]

Originally Posted by RN34TX

Your patient needs an A-line.
That's what we do for those patients on that insulin protocol.

How about a central line?

[CCURN]

A line would be nice

[moonshadeau]

Sometimes when fingers get sore from frequent finger sticks, we use earlobes. Ears don't seem to clamp down as easily as other peripheral areas. Works pretty well.

[mountain_rn]

A-Line, TLC, PICC. Also would definatley re-evaluate EBP issues on q30 min accuchecks. Have used forearm in past and have noted BG's to be basically the same.