Glucose meter testing in OR specimen collected via earlobe stick?
Does anyone out there have glucose testing being done in their ORs with specimens collected via an
earlobe stick?
Our anesthesia department has implemented a Q1 hour protocol for monitoring glucose in the OR for long procedures on diabetic patients, without the input from out POCT department and without a validation. This practice changes the complexity
of this testing. The reasoning that we are being given for this is that the patient is draped, so the earlobe is the most accessible. However, all OR patients have at least an IV that must be accessible if an emergent issue arises.
Has anyone validated earlobe sticks AND/OR can anyone share how glucose levels are being monitored in your OR?
Diana Willoughby, B.S. MT (ASCP)
Point-Of-Care Coordinator
Duke Regional Hospital - DUHS Clinical Labs
POC Office: 919-470-8257
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The Roche meters are not FDA approved for earlobes. We tell them to either use the finger or get it out of a vein
HI Diana,
I went through this a year ago. It started with just the colon surgeries. Studies found that there were better outcomes if the glucose was monitored hourly.
They asked if they could use the ear lobe since the arms were tucked. We told them no and explained they were not approved by the FDA, high complexity, huge validation study...and they said OK. One day I noticed that they were doing BGMs in duplicate. I called the tech and she told me that the first ones were from earlobe and second from finger. The doc told her to do it but didn't realize it was going on patient chart and it had to be organized through lab. My director backed me and now they have to leave one arm out for finger and armband access.
Last November I was asked to train the CRNAs to do BGMs. Reason....this initiative is expanding to ortho and other surgeries also so this isn't going away. I was lucky, anesthesia didn't want to do a big study.
Hope this helps.
Lois.snider@stclair.org
Thank you! That is our contention exactly. However, the anesthesia group is stating that this as "standard practice." I want to do my due diligence to collect information to show that it is not standard. I appreciate your time. Diana
Fortunately for us, the barcode on the wristband is the only thing that can be used for the glucometer. Chart labels are invalid, so if you have to access the wrist, you can access a finger. Unless they cut the wristband off
I guess I'd reply that whichever organization deemed by CMS to grant accreditation (eg TJC, DVN) to the anesthesia group to practice there doesn't go by 'standing practice'...they go by 'best practice' and in 2019 'best practice' does not include going off label from MIFU.
Doubt that will impact but that's all I can come up with at the moment.