Glucometer

Question 1

Clinical use of glucometers?

Answer 1

Test for Hypoglycemia (which can directly contribute to both morbidity and mortality of patients – more with newborns)
- Glucometers provide a rapid measurement of approximate whole blood glucose level to direct treatment for patients with mild to severe hypoglycaemia.

Question 2

When should blood glucose be tested?

Answer 2

1. Routine: on admission for all
   newborns
2. When signs of hypoglycemia
   are present
   NOTE: If there is no glucometer available and danger signs are present: DO NOT DELAY! Treat for hypoglycemia!

Question 3

How does a glucometer work?

Answer 3

1. Test strip has been treated with
   glucose oxidase
2. Device measures current generated by glucose oxidase reaction to glucose in the blood which is then analysed to determine glucose concentration in either mmol or mg/dL
3. Strip reacts in relation to blood sugar content by color or electric current

Question 4

Types of glucometers?

Answer 4

1. portable
2. bench top

Question 5

Glucose levels in neonatal and adult patients?

Answer 5

neonatal patients - >2.5 mmol/L (45 mg/100 ml)
Adults - < 7.8mmol/L (140mg/L)

Question 6

How do you ensure the glucometer device gives accurate results?

Answer 6

1. Glucometer strips must not be expired
2. Blood sample must be adequate and
   free of contaminating substances
   containing glucose

Question 7

How do you prepare the glucometer for the patient?

Answer 7

1. Gather supplies
2. Wash hands
3. Wear gloves

Question 8

How do you prepare the patient?

Answer 8

1. Assess patient for clinical conditions associated with hypoglycaemia.
2. Clean the skin of a finger
   - for neonates it has to be on the outer edge of the patient’s heel using cotton wool soaked in alcohol.
3. Allow the alcohol to dry before testing.
   Note:
   - Blood glucose samples should never be taken from the finger of a neonate
   - Avoid areas of skin which are poorly perfused, oedematous, inflamed or infected.

Question 9

Infection prevention when using a glucometer?

Answer 9

1. Wash hands
2. Wear gloves
3. Disinfect patient’s skin where
   sample will be taken
4. dispose of strip in hazardous waste container
5. dispose used lancet in sharps container
6. always wipe glucometer with alcohol between patients
7. never reuse strips or sharps

Question 10

Clinical complications when using a glucometer?

Answer 10

1. bruising
2. bleeding
3. nerve or bone damage
4. infection
5. falsely high readings
6. expired glucose strips

Question 11

How do you care for a glucometer?

Answer 11

1. Power: Make sure your device is charged!
2. Storage:
   - Clean, dry secure area
   - Routine place for keeping where it
   won’t be lost or inaccessible
3. Infection Prevention
   - Alcohol 70% between uses
   - And daily by assigned

Question 12

What if glucometer is not turning on?

Answer 12

1. Try charging battery
2. Try inserting a strip
   Still not turning on > maintenance department

Question 13

What if results seem incompatible with
the patient condition?

Answer 13

1. Glucometer strips may be
   expired
2. Insufficient blood sample
3. Heel may be dirty
4. Device not calibrated
   Results still incompatible > maintenance department