Hospital and Telephone Triage

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Blood sugar testing

Video 29 of 91
5 min 11 sec
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Sometimes in triage, we have to check blood sugar. If somebody is drowsy, not responding too well, it may be due to low blood sugar or they may have high blood sugar, they may have diabetes. Anybody with a history of diabetes, blood sugar needs to be done in triage, then you have got these baseline... A baseline measurement that you can carry on treatment referring to that baseline.

So how we do a blood sugar, we always use... We do not use the middle finger, the index finger or the thumb, because those are what you use every day, you do not really use these two fingers very much every day, so if you are not using them too much, you are not going to pick up infections if we have broken the skin. So I usually use the side and not the pad, again because of reasons of infection and because it is quite painful when you have been pricked directly in the pad of your hand there and you touch something afterwards, it can be quite painful. And it is also if you use this inner edge here, it is easy for the patient to put a piece of cloth onto the bleeding point and that will stop the bleeding.

So just clean with water, some people use alcohol. The problem with alcohol is that it will affect the reading if it is not completely dry. So if you are in a rush, you might get a false reading from alcohol, so best just steer away from alcohol. You have got a stabber, what we call a stabber. When you hit the button here, a little needle comes out, only a couple of millimetres, just pierces the skin and creates a wound where the blood can come out.

These are the blood sugar sticks, we call them. This end goes into the machine, this end will test the sugar. So this is the end that you do not want to touch, you can affect the reading by touching this end, so you do not touch that end. Here is the blood sugar machine, it will switch on as soon as you place the blood sugar strip into it. And it will usually give you a visual representation of a drop of blood going onto a tester right there, which is what we have got, so this is now ready to receive a sample of your blood to test for sugar.

So the patient has got a clean finger. We are going to stab on the inside and on the ring finger or the little finger. Quick jag, here we go. So again, with the cloth, you always wipe away, you do not squeeze, it will bleed on its own, if not, you can lower it and gravity will take its course. Wipe away the first sample, the second sample comes through and just place... There we go, a little beep shows that it is done, with the same piece of paper, there you go, press that, it will soon stop bleeding. And we have got a blood sugar reading 5.4.

So what should it normally be? What is a good one and what is a bad one?

Your blood sugar should ideally between 4 and 8 mmol/L.

If it is lower than 4, you have got low sugar, you will feel tired, the fuel is not getting into the cells of your body and you are going to be quite depleted. Also, if somebody has low blood sugar, their behaviour can become erratic, they can often become quite aggressive and combative, it needs correcting immediately. You need to give some sugar orally. We have glucogel and anything sweet into the mouth, the mucosa will absorb the sugar. And if the sugars are above 8, it might be a new reading, the first time the patient has come to a hospital and they said, I am always thirsty, why I am always thirsty, I am weeing a lot. And you take their blood sugar and it is high and it might be the onset of diabetes. But anybody with established diabetes, always take a blood sugar, so you know that their blood sugar is under control.

If I have just had a full meal or something like that, will that affect the reading?

It can do, it can be, it can be high, it will not be too high because your body will control the sugar levels.

But it is something that really we should know if they have just eaten beforehand or something like that, it is worth knowing, yeah?

Yeah, but I would always take the reading and if it is an inappropriate reading, then why is it inappropriate. Try and get some history, some brief history. So when the blood sugar has been taken, you have effectively got a sharp, dangerous, so it needs to go into the sharps box, so I place that into the sharps box and also when you are opening a new bottle or a new carton of testing strips, there will be a plastic calibration strip that you need to calibrate the blood sugar machine with the new blood sugar strips because if they are not calibrated, they will give false readings.