how to finger stick for cholesterol screening?

[bluestates]

I just signed up to do on the spot cholesterol screenings w/a finger stick. i know the screening requires a significant amount of blood to be collected from a single finger stick into a long tube and i was wondering if anyone had any advice on how to perform this procedure effectively? it's hard enough to get an accucheck on some people! i don't want to show up for this new job and not be able to successfully get enough of a sample but i can't find any 'how to' instructions by googling this :-/

thanks very much (to all the nurses who read/post here- i often turn to this site for information, this is the first time i couldn't find an already existing thread for what i was looking for! it's a great resource!)

[SolaireSolstice, BSN, RN]

We use a cholestech http://www.cholestech.com/products/ldx_overview.htm machine that has a capillary tube for cholesterol screenings at the office I work at. You use a normal finger stick (like you would for a glucose screening) but you need to fill the capillary tube up to the mark (I'd say about 2 cc of blood) and then you use a plunger to express the blood onto the cartridge for the machine to read the test. I usually use the middle finger (outer edge) and you often need to have the patient hang their arm down over the edge of the seat and "milk" the finger to keep the blood flowing enough to fill the tube. You just press distally intermittantly toward the finger stick site with your thumb with some pressure, and it usually keeps it open long enough to fill the tube. You have to hold the tube right below the stick site to have the blood flow into the tube, right onto the lower edge of the blood drop that will form and it fills easily and quickly if the blood drop is big enough.

Basically, use the same technique as for an accu-check. Clean the site. Stick the finger. Wipe off first blood show, then milk the finger to fill the capillary tube. Have patient hold pressure on finger stick site while you express the blood onto the cartridge and insert the cartridge into the machine. Then bandage the finger. The machine takes about 2 minutes to read the test, and an error message will report if you didn't get enough blood, or the blood was too old and clotted before you inserted the cartridge. If you don't get the blood onto the cartridge and the cartridge into the machine in the first couple of minutes after you get the sample, it will error.

[P_RN, ADN, RN]

Finger stick cholesterol tests are reported to not be very accurate. Are you a nurse yet?

First determine the person has been fasting for the requisite number of hours. Wipe the finger pad with alcohol, of course you are wearing gloves. Have the tube ready and stick as deeply as the lancet allows. Don't squeeze. Allow the blood to be drawn up by the capillary attraction. The entire process should be complete in 3 minutes.

There is also a paper strip like a glucotest. Neither of these are comparable to what the doctor tests with a real lab test. If you are not toatlly familiar you need one on one instruction or better still sign out and find another volunteer project if you are this unsure.

[sethmctenn]

There is considerable variation in the research about how close the FS cholesterol screening test is to diagnostic lab testing. It's pretty simple to do as mentioned above. One of the differences in doing screenings versus testings is variability in fasting state. When I have done this type of screening test, we always let people know that results outside of the norm should be confirmed with lab tests.

Chloestech.com should have directions on their website for the specific machine used.

http://jama.ama-assn.org/cgi/content/abstract/263/9/1213

http://www.cholestech.com/docs/ldx_accuracy/tbLipid.pdf

[bluestates]

thanks very much, especially to solaire solstace! i've seen the test done but i want to be sure i'm able to pull that much blood into the tube w/out fumbling around or resticking people. your description seems pretty foolproof, hopefully i'll get it right the first time- i'd hate to have to restick anyone or fumble around trying to get blood!