Table of Contents
Introduction
- Wash hands; Introduce self; Patient’s name, DOB and wrist band; Explain procedure and obtain consent
- Ask the patient to wash their hands prior to the procedure with soap and water
Preparation
- Wash hands
- Clean tray
- Place equipment in tray (think through what you need in order)
Equipment list
- Gloves
- Lancet/puncture system
- Glucometer (calibrate glucometer with calibration fluid if necessary)
- Glucometer test strip (insert into glucometer and turn glucometer on)
- Sterile gauze
- Tape
- Return to patient (with tray and a sharps bin)
Procedure
- Wash hands
- Place patient’s hands on a pillow
- Choose lateral/medial border of any finger pulp
- Put on gloves
- Pierce skin with lancet on lateral/medial border of finger pulp
- Discard lancet into sharps bin
- Wipe off the first drop of blood from the puncture site with gauze
- Massage the finger from proximal to distal (to encourage blood flow)
- When a second, large drop of blood accumulates, apply the golden part of the test strip (in the groove at the distal end) to the side of the drop of blood until the glucometer beeps
- Place gauze over the puncture site and apply pressure until it has stopped bleeding
- Tape gauze down over puncture site if needed
To complete
- Thank patient
- Discard test strip/waste and clean tray
- Discard gloves
- Wash hands
- Record the capillary glucose reading in the patient’s notes
Test your knowledge
What would you consider normal and abnormal capillary glucose readings?
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How would you manage a patient with hypoglycaemia?
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What are the diagnostic criteria for diabetic ketoacidosis (DKA)?
- Glucose >11mmol/L (NB. glucose may be normal in some circumstances – ‘euglycaemic DKA’, e.g. if taken insulin recently, on SGLT-2 inhibitor, during pregnancy)
- pH <7.3 or HCO3– <15mmol/L
- Capillary ketones >3mmol/L (or ++ urinary ketones)