Help with understanding the capillary action of glucometers

[Kitty Hawk, ADN, RN]

Hi...

The glucometers we use at our facility are different than what I was used to at the hospital, so I'm finding it's hit or miss with one particular resident who has to get tested 2x during my shift. So rather than hope that he's having a "good droplet day" as it's worse when he's gone to dialysis. I thought I'd try to improve my technique for a sure-fire hit.

What I've come up with, is the test strip works by capillary action and wicks the blood onto it. So other than lightly touching the drop to the strip (I know I shouldn't touch the strip to the finger etc...which will smear it) Is there an angle of up or down that I should hold the strip to the drop of blood ? or should it be parallel for this capillary action to take place?

Mostly I've been having success, but there's been a few misses and I'd like to know what I'm likely doing wrong as it happens so fast to be able to anaylyze exactly how I was holding the strip that it took the sample.

TIA

[netglow, ASN, RN]

Well, if your puncture is lateral on the finger, you'd approach the drop of blood from a direction that is perpendicular to the puncture site. Sometimes it's just that you are thinking of getting it the first time that screws up the probablility of it happening... and you get the people who clot so fast that you need another person to be right there with the meter and hope to get lucky.

[Kitty Hawk, ADN, RN]

Well, if your puncture is lateral on the finger, you'd approach the drop of blood from a direction that is perpendicular to the puncture site. Sometimes it's just that you are thinking of getting it the first time that screws up the probablility of it happening... and you get the people who clot so fast that you need another person to be right there with the meter and hope to get lucky.

Thanks....

Seems it may be subjective to where exactly the drop is as to how to approach it.

When I started with him, I guess the angle was a bit too steep and it seemed when I held it just at the side it worked. I was doing good for a week and then last night I squatted to be level with him and know I approached it pretty much level but it took several tries before it took.

I'm reading that certain glucometers are fussy about the angle so maybe this one requires an ever so slight angle, I'll try that and see.

I wish it was like the PPD test that just requires the going in just under the skin at that 15 degree angle. I've heard some nurses say they thought that was tricky and aren't good at it and getting the wheal etc... and I seem to be okay with that....it's a basic I did all through school that is tripping me up now go figure ...thanks again.

[MissERN]

Perhaps you also might be able to get some information from the manufacturer. I know that when we switched to new glucometers we had an inservice and they actually instructed us to place the test strip on the droplet of blood, and hold it on the finger for about a second. Good luck!