Glucometer use on babies

1. What are your protocols regarding blood sugars on babies? I'm talking low risk newborn nursery stuff here, Specifically:
   
   What is your cutoff for LGA (we do 4000 g but have heard that many places are using 4500 g)?
   
   How many sugars do you do before you call them stable?
   
   What is your policy for SGA and preterm infants (like between 35 - 37 weekers)?
   
   What is your policy for a sugar <40?
   
   Thanks!
2. 

   About AlaskaKat

   Joined: Dec '01; Posts: 86
   OB RN

   8 Comments

   Topic Closed
3. 
   Aug 5, '02

   Joined: Oct '00; Posts: 8,729; Likes: 8,412

   We glucoscan babies greater than 9lb, smaller than 5lb, meconium, apgars less than 7 at one minute, maternal diabetic, or just at the whim of the neonatal nurse.
   
   Those babies falling into our glucoscan protocol get them q1h x4 and then x2 ac.
   
   Those with a glucoscan <40 get a stat lab drawn glucose, and a call to the MD for further orders/notification. Sometimes all we need to do is feed them and continue to moniter, and sometimes the doc wants an IV of D10W, and may come in to assess depending on the baby's history.
4. 
   Aug 5, '02

   Joined: Oct '00; Posts: 10,236; Likes: 64

   We glucoscan all babies that are SGA, LGA, <37 weeks, and maternal diabetes. (and of course prn at my discretion)
   
   <40 requires stat lab draw to confirm, and baby has to eat. Then repeat 1 hour after feed.
   
   SGA's and <37 weekers get them ac for 24 hours. LGA's only have to have 2 consecutive ones >40, and they're done.
   
   Heather
5. 
   Aug 5, '02

   Occupation: Nurse Joined: Aug '99; Posts: 364; Likes: 1

   we glucoscan <2500, >4000, gdm, meconium, fetal distress. they need to have 3 over 40 (one at 30 minutes , 2 hors and 4 hours of age) the first one <40 feed then recheck, 2 <40 call doc. anything less than 25 stat lab draw.
6. 
   Aug 5, '02

   Joined: Jul '00; Posts: 11,351; Likes: 387

   We still do routine glucoscans on high risk infants for the first 24 hours (diabetic moms' infants, SGA, LGA and premies), but they are trying to get away from this and only do glucoscans when baby is symptomatic, which I don't really like. Our babies are considered stable after 2 normal GS in their first 24 hours of life.
7. 
   Aug 7, '02

   Occupation: R.N. Specialty: 27 year(s) of experience in cardiac, diabetes, OB/GYN ; Joined: Feb '02; Posts: 1,947; Likes: 418

   We also routinely check babies over 9 pounds and under 5 pounds. We also are able to do so per nursing, such as with an infant who seems jerky. We do them for infants of gestational diabetics and on those who entered the world with some kind of respiratory distress. We do not routinely do them on mec kids.
8. 
   Aug 7, '02

   Occupation: R.N. Specialty: 27 year(s) of experience in cardiac, diabetes, OB/GYN ; Joined: Feb '02; Posts: 1,947; Likes: 418

   at birth, then 2 hours, 2 hours and 4 hours. We don't like to stick the little kiddos...
9. 
   Aug 9, '02

   Occupation: L&D RN and Childbirth Educator Joined: Dec '00; Posts: 59

   We do blood sugars on any baby 9lb 3oz or more, 5lb 6oz or less, if mom is diabetic (insulin or diet controlled) under 37weeks, or PRN.
   The first is done within 1 hour of life. The protocal is Q 1 hour X3, if all are above 45, it then goes to Q3h AC X12 hours, and VS are done each time as well. If any are below 45 then it is Q 1 hour until you get 3 in a row above 45, then on to Q3hours. If below 45 then you feed baby and re test in 1 hour
10. 
    Aug 12, '02

    Joined: Jul '01; Posts: 2,151; Likes: 86

    Forgive the ingnorance...what is glucoscan? Is this different than using a lancet?

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