BLOOD GLUCOSE

MONITORING
Prepared by:
Mr. Ronnie N. De Vera, RN MANc
Clinical Instructor
NOTE
Information within this presentation
should be tailored to the Blood
Glucose Measuring Device used by
the service and should include a
review of the manufacturer’s
instructions.
Objectives
 At the conclusion of this program
participants will be able to:
State when blood glucose
measuring is indicated
Describe the importance of a full
patient assessment in conjunction
with test results
Demonstrate accurate calibration
Demonstrate appropriate
procedures for measuring blood
glucose
Target Blood Sugar Ranges

Fasting: 90-120 mg/dl


Before meals: 90-120 mg/dl


Two hours after meals: Less than
180 mg/dl


Indications for BG
Monitoring
 Signs and Symptoms consistent
with
Acute Stroke
Altered Mental Status
Known Diabetic Patient
Trauma with potential for
Head/Spinal Injury
Combative Patient
Seizures
Overdose
 Altered
Mental Status
(Common Causes)
AEIOU-TIPS
 Alcoholism Trauma
 Epilepsy Infection
 Insulin Psychiatric
 Overdose Stroke
 Underdose

Target Ranges
 KKeeping your blood sugar in range will
lower your risk of complications
Blindness
Heart disease
Kidney problems
Sexual dysfunction
Nerve damage
 eeping your blood sugar in range will lower your risk of complications
• Blindness
• Heart disease
• Kidney problems
• Sexual dysfunction
• Nerve damage
Prevention of Complications

Glucose control
Blood pressure control
Blood lipid control
Preventive care practices for
eyes, kidneys and feet
Smoking cessation

Why Check Your Blood Sugar?

Checking your blood sugar every

day can help
you learn

how well your medication is

working
how different foods affect your
blood sugar
how exercise affects you blood
sugar
why you are having highs and
Frequency and Timing of Monitoring

 Pills
1 or 2 times a day
Variety of times
 Fasting
 Before meals
 2 hours after meals
 Bedtime

Frequency and Timing of
Monitoring
 Insulin
3 or more times a day
Fasting
Before meals
2 hours after meals
Bedtime

Remember…..

 Check blood sugar

 when you suspect a low!
Hypoglycemia

Bloodsugar less than 70

Symptoms include
 shaking
sweating
nervousness
feeling irritable
blurry vision or headache
feeling tired
no symptoms

Treatment of Hypoglycemia

Have one portion of fast-acting

sugar
 4 oz fruit juice
3 glucose tablets or 1 tube glucose gel
1 tablespoon honey or sugar
Wait 15 minutes. Recheck blood
sugar.
If blood sugar is still less than 70
repeat.
If blood sugar is above 70 eat a
snack or meal within 1 hour.
What Makes Blood Sugars Go Up?

Food
Not enough diabetes pills/insulin
Certain medicines
Infection/sickness
Surgery
Stress
Menstrual period

What Makes Blood Sugars Go Down?

Diabetes pills
Insulin
Exercise

What Can You Do to Control Your
Blood Sugar?
Check your blood sugar regularly
and write the numbers down!
Walk every day for at least 30
minutes.
Eat smaller portions. Eat at least
6 small meals per day.
Show your logbook to your doctor
and discuss any patterns or
problems.

Pre-Hospital Care


1. Scene Safety/Survey

2. Perform initial assessment

 Considering/Treating ABC’s
 3. Ensure cervical spine immobilization as indicated


•



Pre-Hospital Care
 4. Perform focused history and
physical exam
(a). SAMPLE history


1.Signs/Symptoms (when did they start?;

how long did they last?)
2.Allergies
3.Medications (When last taken?)
4.Prior Medical History (diabetes?, seizure
disorder?)
5.Last oral intake (When did patient last
eat)?
6.Events leading to illness/injury
7.
Pre-Hospital Care
5. Focused history & physical exam,
cont.
 (b). Take base line vital signs

 (c). Determine blood glucose level

 (d). Evidence of

hypothermia/hyperthermia?
 (e). Can the patient swallow

normally?

Pre-Hospital Care
Do not administer anything orally
if the patient does not have a
reasonable level of
consciousness and normal gag
reflex.
Contact medical control prior to
administering glucose to
patients suspected of Acute
Stroke/Head/Spinal Injury.

Pre-Hospital Care
6.If patient is unconscious or
seizing, transport on left side.
7.If patient’s BP drops below 100
systolic; treat for shock
8.Monitor VS every 5 minutes if
unstable; every 15 minutes if
stable.

Glucose Measuring Devices

Usedto Check Blood Sugar Levels

Many different types and models

Procedures:
Careful attention to BSI & safety
Select Finger
Massage blood into distal end
Clean finger with appropriate aseptic
technique
 (if using alcohol, let dry or wipe dry with
sterile gauze)
Use lancet or Auto-lancet device
Apply drop of blood onto test strip and
follow individual glucometer
instructions
Dispose of sharps and soiled supplies
Device & Accessories
Test Strips
Glucometer

Lancet
Glucose Measuring Steps
 Step #1 Step #2 Step #3

Locate
Glucometer

Open Up Case

Turn Power On
Device Variations

Some glucometers turn on automatically.

Know the features of the glucometer your service uses.
Glucose Measuring Steps, cont.

Confirm Codes
Glucose Measuring
Steps , cont .
Step #5

Insert Test Strip

 Glucose Measuring Steps, cont.
Step #6

Obtain Blood Sample

Glucose Measuring Steps, cont.
Step #7
 Apply Drop of Blood

If inadequate up to 15 secs., add additional

blood
Glucose Measuring
Steps , cont .
 Step #8

Document Results
Results
• Measured in milligrams per deciliter
• Normal blood glucose range is typically
 80-120 mg/dl (fasting)
• Treat the patient, not the numbers



Maintenance and
Calibration
• FOLLOW MANUFACTURER’S
RECOMMENDATIONS:
• Techniques
• Frequency
• Batteries
• Care & Storage
– Device
– test strips
• Temperature Can Affect Machine Accuracy!!!!
•

Documentation
• Reasons for procedure
• Time of procedure
• Results of procedure
• Response to treatments
• Changes in signs/symptoms

GOOD LUCK AND THANK YOU!