Question about capillary blood glucose testing

[MaryPatricia]

Hi,

My patient had wrist surgery, ace wrap with splint right arm, IV left hand. Only thumb visible on operative right side. Thumb was cool and difficult to extract blood from.

Is it permissible to check blood sugar from alternative site, such as an earlobe?

What about labs? If they were needed, would I have to get some resident to do a femoral stick?

I work in outpatient surgery, so we don't come across this scenerio too often, as patients are discharged soon after admission if they are stable and pain is under control. I ended up transferring this lady to med- surg bed as she had intractable postop nausea and vomiting despite 3 different antiemetics and IV fluid boluses.

[jesa]

could you not use the left hand?

[kids]

Yes, there are CBG machines/strips/lancets that allow for testing from alternate sites but in the situation you mention there is no 'need' for one.

You could have used the a a digit on the left hand, because it is proximal to the test site the IV would have no effect in the results.

As for labs, a femoral stick is excessive.

You can stop the IV fluids for 5 minutes then do an AC stick as usual (whether or not you need an order to interrupt the fluids will be up to hospital policy). Or you can get an order to draw from a leg vein.