accucheck finger choice??

AssociateDegree · Mar 17, 2014

It's fine to use a calloused finger (Type 1 diabetics tend to have lots of callouses), but you may need an adjustable lancing device that can go deeper to get the sample.

melcolbstorm · Mar 18, 2014

awesome!!! Thanks for the tip!

akulahawkRN, ADN, RN, EMT-P · Mar 18, 2014

If you still aren't able to get a sample even after using longer lancets or slightly different spots on the fingers, you might want to find out if your glucometers are capable/calibrated for alternative site testing, such as forearms. If so, perhaps you could advocate for using alternate sites for testing because sometimes the fingers do get calloused to the point where it's difficult or nearly impossible to obtain a sample using the usual sites.

AssociateDegree · Mar 18, 2014

If you still aren't able to get a sample even after using longer lancets or slightly different spots on the fingers, you might want to find out if your glucometers are capable/calibrated for alternative site testing, such as forearms. If so, perhaps you could advocate for using alternate sites for testing because sometimes the fingers do get calloused to the point where it's difficult or nearly impossible to obtain a sample using the usual sites.

Agree, but just make sure you are aware of the limitations of alternate site testing in cases of severe hypoglycemia.

funtimes · Mar 18, 2014

I've literally never not been able to get a blood sample, no matter how calloused their fingers are, so I cant see this as being an issue, but the lancets we use could probably pierce metal(patients complain about them all the time).

I've heard it said that you shouldn't squeeze or milk the finger as it can affect the reading, but it can be pretty hard, if not impossible to get enough blood if you don't for some people. I've conducted a little experiment on myself where I squeezed the finger hard and milked it, and took another reading without doing that, and got the same result, but maybe on some people it can matter if say they have edema.

Warming the hand and dangling the fingers off the end of the bed can help, but often that's not really possible or the patient isn't cooperative enough. Also some places require you to wipe the first drop of blood away and then check, others don't. I always wait a good while to make sure the alcohol is dry before I poke as I've heard that'll affect the reading if you don't, but I see plenty of nurses just wipe and then poke a few seconds later.

MrChicagoRN, RN · Mar 18, 2014

^ you should use a 2nd drop sample, but not an alcohol wipe. Alcohol can affect the reading. Use a small piece of gauze instead.

AssociateDegree · Mar 19, 2014

^ you should use a 2nd drop sample, but not an alcohol wipe. Alcohol can affect the reading. Use a small piece of gauze instead.

You use an alcohol swab to cleanse the finger, poke the finger with a lance, get a blood drop, wipe it off with a gauze pad, and use the second drop, because alcohol can dilute the sample.

MrChicagoRN, RN · Mar 19, 2014

That's what I meant to say. Thanks for the clarification.

JDZ344 · Mar 24, 2014

It's fine to. Some patients all their fingers will be like that