trouble with blood glucose check

Jul 13, 2008 04:34 PM

by turtle rain

Hi all,

I just experienced my 2nd day of clinicals and had a horrible time getting enough blood for the glucometer to read. I understand the procedure from class and was successful with it in our lab. But, I simply could not get enough blood from either one of my elderly ladies for the glucometer to read. What do you do when you prick the finger and very little or no blood comes out???

What am I not doing right?

MegRN2B · Jul 13, 2008, 04:40 PM

Re: trouble with blood glucose check

If the hands are cold or if the patient has poor circulation in their hands, it's common to have too little blood for a glucose check. If you "milk" the blood from the base of the finger towards the fingertip before and after the poke, often you will get enough blood. Try not to squeeze the tip of the finger, though, because it can occlude blood flow and make things worse. Hope this helped

casi · Jul 13, 2008, 05:26 PM

Re: trouble with blood glucose check

I tend to give my patients a hand massage before I stick them. Especially if I'm waking them up and their hands are cold.

Otherwise if you poke them and you aren't getting a lot of blood I do a quick gental finger/hand milking.

mauxtav8r · Jul 13, 2008, 05:28 PM

Re: trouble with blood glucose check

Warm the hands up first. Warm wash cloths help. Milk BEFORE sticking. Stick the finger when it's nice and pink.

Guitar_Heroine · Jul 13, 2008, 05:28 PM

Re: trouble with blood glucose check

Also it helps to have gravity on your side and hang their arm over the side of the bed and so that the palm faces down. Sometimes it seems to work better for me if I squeeze above and below the puncture. I try to really aggressively swab the finger with alcohol first too to get some circulation going. If they're with the program I'll have them "warm up a finger" for me while I'm getting set up.

*BSNDec06* · Jul 13, 2008, 05:38 PM

Re: trouble with blood glucose check

Just be aware that excessively massaging the hands or "milking" the fingers while trying to get blood from a stick can result in dilution of the sample from tissue fluid contamination.

A little prep-work (warming the hands, holding them in a dependent position, etc.) can save time on the back end for sure!

*AirforceRN* · Jul 13, 2008, 05:53 PM

Re: trouble with blood glucose check

I found when I first started with "real" patients I was hesitant with the poker and often needed to poke twice. Make sure you have good pressure on the finger with the poker before you release the sharp.

bethem · Jul 13, 2008, 06:17 PM

Re: trouble with blood glucose check

Originally Posted by AirforceRN

I found when I first started with "real" patients I was hesitant with the poker and often needed to poke twice. Make sure you have good pressure on the finger with the poker before you release the sharp.

That's what I was coming to say - if you're too 'nice', it can backfire because you have to prick again! Get that latent aggression out, make sure you're pressing hard enough!

(Obviously not too hard. Do it to yourself a few times and see how hard you have to prick. No bruises!)

turtle rain · Jul 13, 2008, 06:26 PM

Re: trouble with blood glucose check

thanks for the quick replies - I'll try your suggestions next Saturday and let you know if it goes any better

Pax_Ramona · Jul 13, 2008, 08:35 PM

Re: trouble with blood glucose check

Hi Turtle,
All good suggestions so far. I would add not to stick directly on the pad (center) of the finger but a little to the side. Many people have callous build up on the pads of their fingers.

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trouble with blood glucose check

trouble with blood glucose check

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