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In order to provide advance care to a diabetic patient, paramedics initially take the blood glucose level of the patient. Hand’s area for blood glucose testing is cleaned by applying alcohol and then letting it dry. Fingertip will be prick by a lancet – a needle like device. After pricking the fingertip, hand is held down and a drop of blood is squeezed from the pricked area. The drop of blood is applied in the test strip and be inserted in the glucometer. Then, the glucometer displays the blood glucose level (Manthappa, 2008, p. 68).
Blood glucose monitors such as glucometers are an important tool for people with diabetes. Glucometers assess diabetic people’s physiological status and assess the needs for adjusting medication dose or meal frequencies. Glucometers are very helpful most especially during the hypoglycemic attack. If hypoglycemia is not treated, it will result in autonomic, cognitive and affective disruption, acute brain damage, coma, or worst, death (Steptoe, 2010, p. 825).
Hypoglycemia is defined as the fall in blood glucose levels and is the most common and dreaded complication of diabetes. Hypoglycemia occurs when timing of meals or exercise does not match with the timing of insulin injections. Critical hypoglycemic attack often happens at night and signs such as presence of nightmares, excessive perspiration, and waking up in the morning with a headache are manifested. Some patients may go from feeling normal to unconsciousness within a few minutes (Molitch, 1990, p. 182-194). Thus, taking blood glucose level before taking medications or insulin is very important in preventing hypoglycemia. Glucometer testing utilizes capillary blood samples. It is easy to use, is quick, and does not require blood to be wasted. In fact, it only uses a drop of blood. Having a glucometer prevents the health care provider from leaving the patient unattended by using a blood gas analyzer for glucose measurements. However, blood glucose level measurement’s through a glucometer has been found to be the least accurate method of measuring glucose levels when compared to laboratory results (Bench, 2011, p. 120). Kanji et al. (2005) found that capillary sampling over-estimated blood glucose significantly, and in cases of hypoglycemia, results using this method agreed with laboratory results only 26.3% of the time. To ensure accuracy of the measurements, health providers preferred the arterial sample for glucometer testing over the capillary blood sample and are thus recommended in blood glucose monitoring. Arterial blood sampling via arterial catheter is used to measure blood gases and electrolytes. It is sometimes called blood gas analyzer. The used of arterial blood sample in a glucometer is considered to be the most accurate and the most reliable method of measurement when compared to laboratory testing. However, frequent arterial sampling may lead to air embolus, infection, and anemia in critically-ill patients (Bench, 2011, p. 120). Thus, samples must be taken using a non-touch technique with some support for closed blood sampling circuits to allow blood return to the patient and prevent incidence of anemia. Because of the long duration of waiting for the laboratory results of blood glucose level and the physician’s requirements, glucometers became extremely popular. Glucometer reading is not as accurate as laboratory blood glucose measurement. There are some limitations with regards to the use of glucometer. First, the accuracy of glucometer test results depends partly on the quality of the meter, test strips, and training. The strip must always be compatible with
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