Glucose Testing

[nurseob7]

What device are you using to get blood from baby for glucose level? We are using the tenderfoot -- same device that we are using for metabolic screening (PKU's) -- I think with this device you usually get more blood than needed for a glucose test and am just starting to research and see if we should change our current practice. Thought maybe something different would be less painful also. Thanks!!

[Mimi2RN, ASN, RN]

I agree. Instead of using a heel warmer, I'll do what we used to before they were invented - a very warm, wet washcloth wrapped around the foot and ankle, secured in a diaper. (I actually prefer to do this for all my labs - heelwarmers don't work half as well as our old method!) The warm, moist heat really helps bring blood to the surface, plus the wetness will soften scabs from old heelsticks. When you unwrap, all you have to do is rub an alcohol swab (or saline wipe if that's what your unit uses) and a sterile 2x2 over the heel and more than likely you'll get a drop of blood from somewhere.

You have to be very careful! We had a baby brought in to our unit with blisters on a foot from someone doing this.

We use Quickheel lancets for everything, as our manager didn't want to spend money on two kinds of lancets. Maybe this should be our next Unit Based Council project.......I hate seeing feet turned into mincemeat. I may try the 25ga needle stick instead.

[Gompers, BSN, RN]

You have to be very careful! We had a baby brought in to our unit with blisters on a foot from someone doing this.

Don't worry - we had to do this for YEARS before we got the heel warmers. We just use very warm water - not hot. Our water on the unit doesn't get very hot to begin with. I mainly do this on bigger kids - the tiny ones do just fine with the heel warmers. It's the kids where the warmer is just on the heel but the rest of their foot is hanging out, that's when I find that warming the whole foot - ankles to toes - works better than just doing the heel.

[rnpilot]

I hate heal warmers. It's often hard to get them to stay on. I prefer the wash cloth meathod with the caveat that one has to be careful not to leave a baby with a cold, wet foot because something came up. I'm pretty sure this was why we got heal warmers years ago because they do cost money.

[justjenny]

I hate heal warmers. It's often hard to get them to stay on. QUOTE]

I agree but I solve this by putting a small piece of tape across it to secure. The little "sticky" that is attached to our heel warmers does not hold and the next thing you know, they have kicked 'em off! The tape holds it in place well, and we have a clear tape that tears very easily for fast removal.

Jenny

[rnpilot]

Even with tape, somehow they still get them to come off. They wait till we're not looking. LOL.

[dawngloves, BSN, RN]

Not to stray OT, but wasn't there a British study years ago that said heel warmers don't make that big a difference? I don't use them every single time, if I know the kid is a really good bleeder and I never use them to get blood sugars.

[elizabells, BSN, RN]

We use... wow. I can't remember the name right now. They're lavender and oval, and I've used them on kids from

[Gompers, BSN, RN]

We use... wow. I can't remember the name right now. They're lavender and oval, and I've used them on kids from

We use those too, they're preemie lancets. We don't usually warm the heel if it's just an accucheck because only a tiny drop is needed, but you really should be using something to warm them up if you're doing other labs. It really does make a world of difference and you don't have to pump and milk the poor baby's leg/foot, which can cause damage.