Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 Sure, just follow the manufacturers directions for prescribing Vioxx and you won't get sued. E. Bledsoe, DO, FACEP Midlothian, TX Don't miss EMStock 2005 (http://www.EMStock.com) Re: Glucometers My, how insightful. Mike > What ever! > BH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 Sure, just follow the manufacturers directions for prescribing Vioxx and you won't get sued. E. Bledsoe, DO, FACEP Midlothian, TX Don't miss EMStock 2005 (http://www.EMStock.com) Re: Glucometers My, how insightful. Mike > What ever! > BH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 Sure, just follow the manufacturers directions for prescribing Vioxx and you won't get sued. E. Bledsoe, DO, FACEP Midlothian, TX Don't miss EMStock 2005 (http://www.EMStock.com) Re: Glucometers My, how insightful. Mike > What ever! > BH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 I don't think you do blood glucose readings with vioxx, and the last time I checked Paramedics don't prescribe vioxx either. But if you are using a piece of equipment, one should follow the instructions. I can't believe someone as learned as you would fall into this stupid discuss. I guess my expectations were higher.\ BH Re: Glucometers My, how insightful. Mike > What ever! > BH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 I don't think you do blood glucose readings with vioxx, and the last time I checked Paramedics don't prescribe vioxx either. But if you are using a piece of equipment, one should follow the instructions. I can't believe someone as learned as you would fall into this stupid discuss. I guess my expectations were higher.\ BH Re: Glucometers My, how insightful. Mike > What ever! > BH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 I don't think you do blood glucose readings with vioxx, and the last time I checked Paramedics don't prescribe vioxx either. But if you are using a piece of equipment, one should follow the instructions. I can't believe someone as learned as you would fall into this stupid discuss. I guess my expectations were higher.\ BH Re: Glucometers My, how insightful. Mike > What ever! > BH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 I think his point was - manufacturer's recommendations are one thing. Hard science is another. We don't treat based on manufacturer's recommendations - we're trying to treat based on science... more and more. FWIW, we don't need a lab in the back of the ambulance. But, like anything else, we need to understand WHY we're seeing the results we're seeing with any machine, whether it be a glucometer, a cardiac monitor or a field troponin assay machine. So, back to the question - is there SCIENCE on whether isopropyl alcohol interferes with blood glucometry readings, either in glucometers or in actual lab-based assays. Same question for ethyl alcohol. BTW, you do know that according to the manufacturer's spec, a person with long-term exposure and binding to CO has a perfectly fine pulse oximetry number, right? But a lab assay (and a thorough examination in field, as well) will reveal the physiology behind those numbers. Mike > I don't think you do blood glucose readings with vioxx, and the last > time I checked Paramedics don't prescribe vioxx either. But if you are > using a piece of equipment, one should follow the instructions. > I can't believe someone as learned as you would fall into this stupid > discuss. I guess my expectations were higher.\ > BH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 I think his point was - manufacturer's recommendations are one thing. Hard science is another. We don't treat based on manufacturer's recommendations - we're trying to treat based on science... more and more. FWIW, we don't need a lab in the back of the ambulance. But, like anything else, we need to understand WHY we're seeing the results we're seeing with any machine, whether it be a glucometer, a cardiac monitor or a field troponin assay machine. So, back to the question - is there SCIENCE on whether isopropyl alcohol interferes with blood glucometry readings, either in glucometers or in actual lab-based assays. Same question for ethyl alcohol. BTW, you do know that according to the manufacturer's spec, a person with long-term exposure and binding to CO has a perfectly fine pulse oximetry number, right? But a lab assay (and a thorough examination in field, as well) will reveal the physiology behind those numbers. Mike > I don't think you do blood glucose readings with vioxx, and the last > time I checked Paramedics don't prescribe vioxx either. But if you are > using a piece of equipment, one should follow the instructions. > I can't believe someone as learned as you would fall into this stupid > discuss. I guess my expectations were higher.\ > BH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 I think his point was - manufacturer's recommendations are one thing. Hard science is another. We don't treat based on manufacturer's recommendations - we're trying to treat based on science... more and more. FWIW, we don't need a lab in the back of the ambulance. But, like anything else, we need to understand WHY we're seeing the results we're seeing with any machine, whether it be a glucometer, a cardiac monitor or a field troponin assay machine. So, back to the question - is there SCIENCE on whether isopropyl alcohol interferes with blood glucometry readings, either in glucometers or in actual lab-based assays. Same question for ethyl alcohol. BTW, you do know that according to the manufacturer's spec, a person with long-term exposure and binding to CO has a perfectly fine pulse oximetry number, right? But a lab assay (and a thorough examination in field, as well) will reveal the physiology behind those numbers. Mike > I don't think you do blood glucose readings with vioxx, and the last > time I checked Paramedics don't prescribe vioxx either. But if you are > using a piece of equipment, one should follow the instructions. > I can't believe someone as learned as you would fall into this stupid > discuss. I guess my expectations were higher.\ > BH Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 May I have your attention, Ladies and Gentlemen? Is there an FDA administrator in the audience? We have a glucometer emergency behind stage here and need a government administrator immediately. I repeat, is there an FDA administrator in the audience? GG > > > 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 > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 May I have your attention, Ladies and Gentlemen? Is there an FDA administrator in the audience? We have a glucometer emergency behind stage here and need a government administrator immediately. I repeat, is there an FDA administrator in the audience? GG > > > 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 > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 May I have your attention, Ladies and Gentlemen? Is there an FDA administrator in the audience? We have a glucometer emergency behind stage here and need a government administrator immediately. I repeat, is there an FDA administrator in the audience? GG > > > 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 > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 Wipe with clean tissue don't wipe and wipe with alcohol prep on the same subject and see the difference. -------------------------------------------------------------------------------- Re: Glucometers 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 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 Wipe with clean tissue don't wipe and wipe with alcohol prep on the same subject and see the difference. -------------------------------------------------------------------------------- Re: Glucometers 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 > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 I was taught that the first blood drop was considered unusable and wipe it off and take the second one if you are in doubt about alcohol use a sterile 2/2 and then proceed. -------------------------------------------------------------------------------- Re: Glucometers > 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 I was taught that the first blood drop was considered unusable and wipe it off and take the second one if you are in doubt about alcohol use a sterile 2/2 and then proceed. -------------------------------------------------------------------------------- Re: Glucometers > 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 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2005 Report Share Posted May 13, 2005 I was taught that the first blood drop was considered unusable and wipe it off and take the second one if you are in doubt about alcohol use a sterile 2/2 and then proceed. -------------------------------------------------------------------------------- Re: Glucometers > 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 Quote Link to comment Share on other sites More sharing options...
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