Haven't yet convinced anyone to redo hypoglycemia protocols
significantly, despite generous distribution of the WHO review of the
literature.  However, I do have a suggestion on use of the reagent
sticks and meters.  If you are having more than usual numbers of low
blood sugars, see if your lab will do simultaneous blood tests on the
same blood sample, then have the rep for the company that makes the
meters make adjustments in your meters.  We did this, and it helped a
lot.

True story re reliability.  Watched a new nurse doing a blood sugar
test.  She didn't warm the heel (protocol, well-posted, but almost never
done) and she squeezed a lot.  I think she also got a bubble on the
reagent paper.  Results: 19 mg.%.  I asked to redo the test and show her
how to do it.  My results were 47 mg.%.  To get anything close to
accurate results, technique must be flawless.  You can't just wipe off
the clot from an old stick; you must dry the foot after wiping with
alcohol (or use soap and water and rinse); the heel needs to be warm;
you can't squeeze; you can't get bubbles on the reagent stick.

--
Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA
mailto:[log in to unmask]