2. Indications for BG Measuring
Signs and Symptoms consistent with
Acute Stroke
Altered Mental Status
3. Hypoglycemia
Blood glucose level of 80 or less
Most calls for diabetic emergency
Signs and symptoms:
Hunger
Nervousness or shakiness
Perspiration
Dizziness or light-headedness
Sleepiness or weakness
Confusion
Difficulty speaking
Unresponsiveness
4. Hyperglycemia
Blood glucose level of 120 or higher
Most common but least calls to EMS
Signs and symptoms:
Frequent urination
Increased thirst
May lead to Ketoacidosis
5. Procedures
Careful attention to BSI & safety
Insert Glucometer test strip into device
Select Finger
Massage blood into distal end
Clean finger with alcohol & allow to dry
Use lancet or Auto-lancet device
Wipe first drop of blood off
Apply drop of blood onto test strip and follow
individual glucometer instructions
Dispose of sharps and soiled supplies
7. Step 2
Get out a lancet (prepare the lancet as needed)
Locate the place for the finger-stick:
Choose a finger… any finger (usually not the thumb)
Use the side of the pad of the finger, between the
knuckle and the finger tip
If the patient has callused fingers or thick skin it maybe
difficult to get blood, try to find a place with “thinner”
skin
As EMT providers we are not authorized to use
alternate site testing (IV starts, toes, arms, etc.) if
fingers are not available, medical control must be
contacted for orders to test an alternate site
8. Step 3
Clean the finger tip that you will be
performing the finger-stick on with an alcohol
prep pad
Be sure the area dries completely, use a
sterile gauze pad to dry the area if needed
Note: un-dried alcohol may skew the reading
so make sure it dries completely
9. Step 4
Lance the finger with the lancet
Lower the hand and squeeze the finger
gently (if needed) to assist with
producing a small droplet of blood
11. Step 6
When the blood glucose reading appears,
document it immediately on the ePCR
Ex: “blood glucose 100 at 13:57”
Continue to treat the patient per Maryland
Medical Protocol
12. Troubleshooting
What could go wrong when using the glucometer?
Dead batteries
Always carry spare batteries in the ambulance and
check the unit regularly
“Error” reading appears
Insert a new strip, re-test, check batteries
Unable to get enough blood from finger-stick
Lance a different finger, if skin is cold-try warming with
a hot pack wrapped in a towel
Inaccurate reading
Why do you think it was inaccurate? Was the alcohol
dried? Was the strip contaminated? Try re-testing.
13. Results
Normal blood glucose range is typically
If it reads “LO” = lower than 20 mg/dl
If it reads “HI” = higher than 500 mg/dl
If it reads “E-3” = may be too low to read
If it reads “E-4” = may be too high to read
Any of these readings could also indicate that there is a
problem with the test strip. Remember to treat the patient
and not the number on the meter.
80-120
14. Maintenance & Calibration
Techniques
Frequency
Batteries
Care & Storage
Device
Test strips
Documentation