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Re: Glucometers

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I've always cleaned the area with an alcohol prep pad, waited for it to dry,

then obtained a blood draw. I've never seen it done any other way.

Are these people using some other prep pad like Betadine?

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

Glucometers

I have seen more and more people not use alcohol wipes for blood sugar

readings. Can the wipes give you a false reading? I always waited

till the alcohol dried before I stuck their finger. Any thoughts?

Lee

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Guest guest

I've always cleaned the area with an alcohol prep pad, waited for it to dry,

then obtained a blood draw. I've never seen it done any other way.

Are these people using some other prep pad like Betadine?

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

Glucometers

I have seen more and more people not use alcohol wipes for blood sugar

readings. Can the wipes give you a false reading? I always waited

till the alcohol dried before I stuck their finger. Any thoughts?

Lee

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Guest guest

I've always cleaned the area with an alcohol prep pad, waited for it to dry,

then obtained a blood draw. I've never seen it done any other way.

Are these people using some other prep pad like Betadine?

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

Glucometers

I have seen more and more people not use alcohol wipes for blood sugar

readings. Can the wipes give you a false reading? I always waited

till the alcohol dried before I stuck their finger. Any thoughts?

Lee

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We do the same, Wes. We don't use betadine too much just in case

someone has an allergy to iodine or shellfish.

Val Moczygemba, EMT-I

Eagle Creek Vol. Emerg. Svcs.

County

> I've always cleaned the area with an alcohol prep pad, waited for

it to dry, then obtained a blood draw. I've never seen it done any

other way.

>

> Are these people using some other prep pad like Betadine?

>

> -Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> Glucometers

>

>

> I have seen more and more people not use alcohol wipes for blood

sugar

> readings. Can the wipes give you a false reading? I always waited

> till the alcohol dried before I stuck their finger. Any thoughts?

>

>

> Lee

>

>

>

>

>

>

>

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Guest guest

We do the same, Wes. We don't use betadine too much just in case

someone has an allergy to iodine or shellfish.

Val Moczygemba, EMT-I

Eagle Creek Vol. Emerg. Svcs.

County

> I've always cleaned the area with an alcohol prep pad, waited for

it to dry, then obtained a blood draw. I've never seen it done any

other way.

>

> Are these people using some other prep pad like Betadine?

>

> -Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> Glucometers

>

>

> I have seen more and more people not use alcohol wipes for blood

sugar

> readings. Can the wipes give you a false reading? I always waited

> till the alcohol dried before I stuck their finger. Any thoughts?

>

>

> Lee

>

>

>

>

>

>

>

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Guest guest

We do the same, Wes. We don't use betadine too much just in case

someone has an allergy to iodine or shellfish.

Val Moczygemba, EMT-I

Eagle Creek Vol. Emerg. Svcs.

County

> I've always cleaned the area with an alcohol prep pad, waited for

it to dry, then obtained a blood draw. I've never seen it done any

other way.

>

> Are these people using some other prep pad like Betadine?

>

> -Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> Glucometers

>

>

> I have seen more and more people not use alcohol wipes for blood

sugar

> readings. Can the wipes give you a false reading? I always waited

> till the alcohol dried before I stuck their finger. Any thoughts?

>

>

> Lee

>

>

>

>

>

>

>

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Mike, I can't give you a clinical paper stating that but

in a test in two of our EMT-B classes we had students that

tested their partners with and without wiping the first

drop of blood off after using an alcohol wipe and there

was enough difference between the two readings to presume

the alcohol has an effect. Maybe next time we will

document the test, it might prove to be interesting to see

the results and it might give us another bit of knowledge.

Myron

On Tue, 10 May 2005 21:15:10 -0500

Mike wrote:

> can you cite evidence for that claim, myron? seeing

>that alcohol and

> glucose are very different molecules, I'd tend to want

>proof of that.

>

> Mike :)

>

>

> > Alcohol wipes can cause a false reading on a

>glucometer,

> > but if you wipe the first drops of blood off with a

> > sterile 2x2 you get a good reading. It's always better

>to

> > clean the site to avoid infection. We teach wipe,

> > prick,wipe then take sample.[just my .00002 cents

>worth]

> > Myron Schmiedekamp EMT, Coordinator San Angelo

>Emergency

> > Corp.

> >

> > On Tue, 10 May 2005 18:32:15 -0000

> > " bfd296 " wrote:

> > > I have seen more and more people not use alcohol

> > >wipes for blood sugar

> > > readings. Can the wipes give you a false reading?

> I

> > >always waited

> > > till the alcohol dried before I stuck their finger.

> Any

> > >thoughts?

> > >

> > >

> > > Lee

> > >

> > >

> > >

> > >

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Mike, I can't give you a clinical paper stating that but

in a test in two of our EMT-B classes we had students that

tested their partners with and without wiping the first

drop of blood off after using an alcohol wipe and there

was enough difference between the two readings to presume

the alcohol has an effect. Maybe next time we will

document the test, it might prove to be interesting to see

the results and it might give us another bit of knowledge.

Myron

On Tue, 10 May 2005 21:15:10 -0500

Mike wrote:

> can you cite evidence for that claim, myron? seeing

>that alcohol and

> glucose are very different molecules, I'd tend to want

>proof of that.

>

> Mike :)

>

>

> > Alcohol wipes can cause a false reading on a

>glucometer,

> > but if you wipe the first drops of blood off with a

> > sterile 2x2 you get a good reading. It's always better

>to

> > clean the site to avoid infection. We teach wipe,

> > prick,wipe then take sample.[just my .00002 cents

>worth]

> > Myron Schmiedekamp EMT, Coordinator San Angelo

>Emergency

> > Corp.

> >

> > On Tue, 10 May 2005 18:32:15 -0000

> > " bfd296 " wrote:

> > > I have seen more and more people not use alcohol

> > >wipes for blood sugar

> > > readings. Can the wipes give you a false reading?

> I

> > >always waited

> > > till the alcohol dried before I stuck their finger.

> Any

> > >thoughts?

> > >

> > >

> > > Lee

> > >

> > >

> > >

> > >

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Mike, I can't give you a clinical paper stating that but

in a test in two of our EMT-B classes we had students that

tested their partners with and without wiping the first

drop of blood off after using an alcohol wipe and there

was enough difference between the two readings to presume

the alcohol has an effect. Maybe next time we will

document the test, it might prove to be interesting to see

the results and it might give us another bit of knowledge.

Myron

On Tue, 10 May 2005 21:15:10 -0500

Mike wrote:

> can you cite evidence for that claim, myron? seeing

>that alcohol and

> glucose are very different molecules, I'd tend to want

>proof of that.

>

> Mike :)

>

>

> > Alcohol wipes can cause a false reading on a

>glucometer,

> > but if you wipe the first drops of blood off with a

> > sterile 2x2 you get a good reading. It's always better

>to

> > clean the site to avoid infection. We teach wipe,

> > prick,wipe then take sample.[just my .00002 cents

>worth]

> > Myron Schmiedekamp EMT, Coordinator San Angelo

>Emergency

> > Corp.

> >

> > On Tue, 10 May 2005 18:32:15 -0000

> > " bfd296 " wrote:

> > > I have seen more and more people not use alcohol

> > >wipes for blood sugar

> > > readings. Can the wipes give you a false reading?

> I

> > >always waited

> > > till the alcohol dried before I stuck their finger.

> Any

> > >thoughts?

> > >

> > >

> > > Lee

> > >

> > >

> > >

> > >

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Guest guest

Why are we going back and forth on this subject. The simplest solution

is to follow the instructions that came with each agency's glucometer,

regardless of the brand/make. The instruction manual tells you clearly

what to do and how to do it. Don't make your own rules or procedures,

just follow the manufacturers guidelines.

BH

Re: Glucometers

can you cite evidence for that claim, myron? seeing that alcohol and

glucose are very different molecules, I'd tend to want proof of that.

Mike :)

> Alcohol wipes can cause a false reading on a glucometer,

> but if you wipe the first drops of blood off with a

> sterile 2x2 you get a good reading. It's always better to clean the

> site to avoid infection. We teach wipe, prick,wipe then take

> sample.[just my .00002 cents worth] Myron Schmiedekamp EMT,

> Coordinator San Angelo Emergency Corp.

>

> On Tue, 10 May 2005 18:32:15 -0000

> " bfd296 " wrote:

> > I have seen more and more people not use alcohol

> >wipes for blood sugar

> > readings. Can the wipes give you a false reading? I always waited

> > till the alcohol dried before I stuck their finger. Any

> >thoughts?

> >

> >

> > Lee

> >

> >

> >

> >

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Guest guest

Why are we going back and forth on this subject. The simplest solution

is to follow the instructions that came with each agency's glucometer,

regardless of the brand/make. The instruction manual tells you clearly

what to do and how to do it. Don't make your own rules or procedures,

just follow the manufacturers guidelines.

BH

Re: Glucometers

can you cite evidence for that claim, myron? seeing that alcohol and

glucose are very different molecules, I'd tend to want proof of that.

Mike :)

> Alcohol wipes can cause a false reading on a glucometer,

> but if you wipe the first drops of blood off with a

> sterile 2x2 you get a good reading. It's always better to clean the

> site to avoid infection. We teach wipe, prick,wipe then take

> sample.[just my .00002 cents worth] Myron Schmiedekamp EMT,

> Coordinator San Angelo Emergency Corp.

>

> On Tue, 10 May 2005 18:32:15 -0000

> " bfd296 " wrote:

> > I have seen more and more people not use alcohol

> >wipes for blood sugar

> > readings. Can the wipes give you a false reading? I always waited

> > till the alcohol dried before I stuck their finger. Any

> >thoughts?

> >

> >

> > Lee

> >

> >

> >

> >

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Guest guest

Why are we going back and forth on this subject. The simplest solution

is to follow the instructions that came with each agency's glucometer,

regardless of the brand/make. The instruction manual tells you clearly

what to do and how to do it. Don't make your own rules or procedures,

just follow the manufacturers guidelines.

BH

Re: Glucometers

can you cite evidence for that claim, myron? seeing that alcohol and

glucose are very different molecules, I'd tend to want proof of that.

Mike :)

> Alcohol wipes can cause a false reading on a glucometer,

> but if you wipe the first drops of blood off with a

> sterile 2x2 you get a good reading. It's always better to clean the

> site to avoid infection. We teach wipe, prick,wipe then take

> sample.[just my .00002 cents worth] Myron Schmiedekamp EMT,

> Coordinator San Angelo Emergency Corp.

>

> On Tue, 10 May 2005 18:32:15 -0000

> " bfd296 " wrote:

> > I have seen more and more people not use alcohol

> >wipes for blood sugar

> > readings. Can the wipes give you a false reading? I always waited

> > till the alcohol dried before I stuck their finger. Any

> >thoughts?

> >

> >

> > Lee

> >

> >

> >

> >

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Actually, that would be a relatively easy test to do... I'd love to

see results on that. Have one group do two sticks, one " wiped " and

one " non-wiped, " have the other group do two " wiped " sticks. See if

there's a difference in the two groups...

Mike :)

>

> Mike, I can't give you a clinical paper stating that but

> in a test in two of our EMT-B classes we had students that

> tested their partners with and without wiping the first

> drop of blood off after using an alcohol wipe and there

> was enough difference between the two readings to presume

> the alcohol has an effect. Maybe next time we will

> document the test, it might prove to be interesting to see

> the results and it might give us another bit of knowledge.

> Myron

>

> On Tue, 10 May 2005 21:15:10 -0500

> Mike wrote:

> > can you cite evidence for that claim, myron? seeing

> >that alcohol and

> > glucose are very different molecules, I'd tend to want

> >proof of that.

> >

> > Mike :)

> >

> >

> > > Alcohol wipes can cause a false reading on a

> >glucometer,

> > > but if you wipe the first drops of blood off with a

> > > sterile 2x2 you get a good reading. It's always better

> >to

> > > clean the site to avoid infection. We teach wipe,

> > > prick,wipe then take sample.[just my .00002 cents

> >worth]

> > > Myron Schmiedekamp EMT, Coordinator San Angelo

> >Emergency

> > > Corp.

> > >

> > > On Tue, 10 May 2005 18:32:15 -0000

> > > " bfd296 " wrote:

> > > > I have seen more and more people not use alcohol

> > > >wipes for blood sugar

> > > > readings. Can the wipes give you a false reading?

> > I

> > > >always waited

> > > > till the alcohol dried before I stuck their finger.

> > Any

> > > >thoughts?

> > > >

> > > >

> > > > Lee

> > > >

> > > >

> > > >

> > > >

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Guest guest

Actually, that would be a relatively easy test to do... I'd love to

see results on that. Have one group do two sticks, one " wiped " and

one " non-wiped, " have the other group do two " wiped " sticks. See if

there's a difference in the two groups...

Mike :)

>

> Mike, I can't give you a clinical paper stating that but

> in a test in two of our EMT-B classes we had students that

> tested their partners with and without wiping the first

> drop of blood off after using an alcohol wipe and there

> was enough difference between the two readings to presume

> the alcohol has an effect. Maybe next time we will

> document the test, it might prove to be interesting to see

> the results and it might give us another bit of knowledge.

> Myron

>

> On Tue, 10 May 2005 21:15:10 -0500

> Mike wrote:

> > can you cite evidence for that claim, myron? seeing

> >that alcohol and

> > glucose are very different molecules, I'd tend to want

> >proof of that.

> >

> > Mike :)

> >

> >

> > > Alcohol wipes can cause a false reading on a

> >glucometer,

> > > but if you wipe the first drops of blood off with a

> > > sterile 2x2 you get a good reading. It's always better

> >to

> > > clean the site to avoid infection. We teach wipe,

> > > prick,wipe then take sample.[just my .00002 cents

> >worth]

> > > Myron Schmiedekamp EMT, Coordinator San Angelo

> >Emergency

> > > Corp.

> > >

> > > On Tue, 10 May 2005 18:32:15 -0000

> > > " bfd296 " wrote:

> > > > I have seen more and more people not use alcohol

> > > >wipes for blood sugar

> > > > readings. Can the wipes give you a false reading?

> > I

> > > >always waited

> > > > till the alcohol dried before I stuck their finger.

> > Any

> > > >thoughts?

> > > >

> > > >

> > > > Lee

> > > >

> > > >

> > > >

> > > >

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Guest guest

Actually, that would be a relatively easy test to do... I'd love to

see results on that. Have one group do two sticks, one " wiped " and

one " non-wiped, " have the other group do two " wiped " sticks. See if

there's a difference in the two groups...

Mike :)

>

> Mike, I can't give you a clinical paper stating that but

> in a test in two of our EMT-B classes we had students that

> tested their partners with and without wiping the first

> drop of blood off after using an alcohol wipe and there

> was enough difference between the two readings to presume

> the alcohol has an effect. Maybe next time we will

> document the test, it might prove to be interesting to see

> the results and it might give us another bit of knowledge.

> Myron

>

> On Tue, 10 May 2005 21:15:10 -0500

> Mike wrote:

> > can you cite evidence for that claim, myron? seeing

> >that alcohol and

> > glucose are very different molecules, I'd tend to want

> >proof of that.

> >

> > Mike :)

> >

> >

> > > Alcohol wipes can cause a false reading on a

> >glucometer,

> > > but if you wipe the first drops of blood off with a

> > > sterile 2x2 you get a good reading. It's always better

> >to

> > > clean the site to avoid infection. We teach wipe,

> > > prick,wipe then take sample.[just my .00002 cents

> >worth]

> > > Myron Schmiedekamp EMT, Coordinator San Angelo

> >Emergency

> > > Corp.

> > >

> > > On Tue, 10 May 2005 18:32:15 -0000

> > > " bfd296 " wrote:

> > > > I have seen more and more people not use alcohol

> > > >wipes for blood sugar

> > > > readings. Can the wipes give you a false reading?

> > I

> > > >always waited

> > > > till the alcohol dried before I stuck their finger.

> > Any

> > > >thoughts?

> > > >

> > > >

> > > > Lee

> > > >

> > > >

> > > >

> > > >

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Guest guest

> Why are we going back and forth on this subject. The simplest solution

> is to follow the instructions that came with each agency's glucometer,

> regardless of the brand/make. The instruction manual tells you clearly

> what to do and how to do it. Don't make your own rules or procedures,

> just follow the manufacturers guidelines.

> BH

I think we're trying to determine the difference between what the

manufacturer prints to avoid liability for misuse, and the science

behind glucometry and interference of foriegn substances. For

instance, if isopropyl wipes have an effect, would increased BAC also

have an effect (other than a physiological effect on insulin and blood

sugar, would the alcohol itself change readings?)?

Mike :)

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> Obviously, following the manufacturers instructions would most likely

> provide the best defense against liability! Unless of course we in EMS

> are also bio-chemistry engineers and know better than the manufacturers.

We use them in ways not envisioned by the manufacturer... :)

> I guess the people who manufacture and test these things don't take into

> account all of this issues the we in EMS have come up with. I mean,

> most of these glucometers that we use are right off the shelves of

> Walmart, Sams, Walgreens etc and are designed for Q, public without

> must training to monitor their glucose levels.

Agreed, and they're also not considered as accurate as laboratory

testing performed by qualified blood testing facilities or medical

labs.

> I will stand by my earlier statement that the best and most prudent

> thing to do is follow the instructions. In fact part of the CLEA

> requirement for using Glucometers is to train your personnel and follow

> the manufacturers instructions and guidelines for proper calibration and

> use. I would define misuse as making up our own set of procedures

> contrary to what the manufacturers print.

Which is entirely NOT the point. The point is, scientifically, how do

glucometers work vs. actual blood glucose analysis, and what

biochemical reactions can interfere with that analysis, either in

haldheld units, labs tests, or both. The original question was: can

isopropyl alcohol affect the reading?

To date, there is no posted SCIENTIFIC answer to this question.

Mike :)

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Guest guest

> Obviously, following the manufacturers instructions would most likely

> provide the best defense against liability! Unless of course we in EMS

> are also bio-chemistry engineers and know better than the manufacturers.

We use them in ways not envisioned by the manufacturer... :)

> I guess the people who manufacture and test these things don't take into

> account all of this issues the we in EMS have come up with. I mean,

> most of these glucometers that we use are right off the shelves of

> Walmart, Sams, Walgreens etc and are designed for Q, public without

> must training to monitor their glucose levels.

Agreed, and they're also not considered as accurate as laboratory

testing performed by qualified blood testing facilities or medical

labs.

> I will stand by my earlier statement that the best and most prudent

> thing to do is follow the instructions. In fact part of the CLEA

> requirement for using Glucometers is to train your personnel and follow

> the manufacturers instructions and guidelines for proper calibration and

> use. I would define misuse as making up our own set of procedures

> contrary to what the manufacturers print.

Which is entirely NOT the point. The point is, scientifically, how do

glucometers work vs. actual blood glucose analysis, and what

biochemical reactions can interfere with that analysis, either in

haldheld units, labs tests, or both. The original question was: can

isopropyl alcohol affect the reading?

To date, there is no posted SCIENTIFIC answer to this question.

Mike :)

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Guest guest

What ever!

BH

Re: Glucometers

> Obviously, following the manufacturers instructions would most likely

> provide the best defense against liability! Unless of course we in

> EMS are also bio-chemistry engineers and know better than the

> manufacturers.

We use them in ways not envisioned by the manufacturer... :)

> I guess the people who manufacture and test these things don't take

> into account all of this issues the we in EMS have come up with. I

> mean, most of these glucometers that we use are right off the shelves

> of Walmart, Sams, Walgreens etc and are designed for Q, public

> without must training to monitor their glucose levels.

Agreed, and they're also not considered as accurate as laboratory

testing performed by qualified blood testing facilities or medical labs.

> I will stand by my earlier statement that the best and most prudent

> thing to do is follow the instructions. In fact part of the CLEA

> requirement for using Glucometers is to train your personnel and

> follow the manufacturers instructions and guidelines for proper

> calibration and use. I would define misuse as making up our own set

> of procedures contrary to what the manufacturers print.

Which is entirely NOT the point. The point is, scientifically, how do

glucometers work vs. actual blood glucose analysis, and what biochemical

reactions can interfere with that analysis, either in haldheld units,

labs tests, or both. The original question was: can isopropyl alcohol

affect the reading?

To date, there is no posted SCIENTIFIC answer to this question.

Mike :)

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Guest guest

What ever!

BH

Re: Glucometers

> Obviously, following the manufacturers instructions would most likely

> provide the best defense against liability! Unless of course we in

> EMS are also bio-chemistry engineers and know better than the

> manufacturers.

We use them in ways not envisioned by the manufacturer... :)

> I guess the people who manufacture and test these things don't take

> into account all of this issues the we in EMS have come up with. I

> mean, most of these glucometers that we use are right off the shelves

> of Walmart, Sams, Walgreens etc and are designed for Q, public

> without must training to monitor their glucose levels.

Agreed, and they're also not considered as accurate as laboratory

testing performed by qualified blood testing facilities or medical labs.

> I will stand by my earlier statement that the best and most prudent

> thing to do is follow the instructions. In fact part of the CLEA

> requirement for using Glucometers is to train your personnel and

> follow the manufacturers instructions and guidelines for proper

> calibration and use. I would define misuse as making up our own set

> of procedures contrary to what the manufacturers print.

Which is entirely NOT the point. The point is, scientifically, how do

glucometers work vs. actual blood glucose analysis, and what biochemical

reactions can interfere with that analysis, either in haldheld units,

labs tests, or both. The original question was: can isopropyl alcohol

affect the reading?

To date, there is no posted SCIENTIFIC answer to this question.

Mike :)

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Guest guest

And most of these aren't all that accurate to begin with, even properly

calibrated. I've noticed that during the twice daily tests that we do that

there is sometimes a difference of 10 or so mg/dL using the same test

solution and with test strips of the same lot # for each test. That's with

the low test solution--with the high solution the daily variances are even

more and still fall within the manufacturer's parameters. The high dollar

glucometer that we use in the ER isn't much more accurate.

M. Elliott LP

RE: Glucometers

> I mean,

> most of these glucometers that we use are right off the shelves of

> Walmart, Sams, Walgreens etc and are designed for Q, public without

> must training to monitor their glucose levels.

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Guest guest

No not very insightful, its just that trying to discuss something on

this list server is like talking to a wall. One of the best ways to

avoid litigation is to follow the manufacturers recommendations when

using any type of equipment. I made a simple statement to that point

and get an excuse of WELL WERE TRYING TO FIGURE OUT WAYS TO AVOID

LIABILITY., THEN THE EXCUSE WAS BETTER SCIENCE. Just state your desired

outcome and most science or research will provide you that.

I was just tired of the discussion that was going nowhere. Whether you

wipe with alcohol and not wipe with a sterile 4x4 prior to getting the

drop of blood is a mute point. The glucometer instructions will tell

you the best way to get the best and most accurate reading for that

particular meter. These labs and manufacturers have done extensive

research and testing to obtain the most accurate readings consistantly

for the general public. There might be a slight difference in the

reading out in the field, but as long as your have a basic range that is

high, ok, or low for that patient that is all you need in the field to

treat your patient.

We don't need full blown labs in the back of our ambulances and from

what I've seen and read on this server, that is almost what your

advocating.

I've got plenty of insight, just not the patience for this type of

discussion.

BH

Re: Glucometers

My, how insightful.

Mike :)

> What ever!

> BH

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