ACCURACY OF FINGERSTICK GLUCOSE DETERMINATION IN PATIENTS RECEIVING CPR

被引:16
作者
THOMAS, SH
GOUGH, JE
BENSON, N
AUSTIN, PE
STONE, CK
机构
[1] Department of Emergency Medicine, East Carolina University School of Medicine, University Medical Center of Eastern Carolina, Greenville, NC
关键词
D O I
10.1097/00007611-199411000-00003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Recent demonstration of the dangers of hyperglycemia in the setting of cerebral hypoperfusion has resulted in recommendations to abandon the long-standing practice of empiric administration of dextrose to patients with altered mental status. Patients receiving basic cardiopulmonary resuscitation (CPR) have been identified as being at particular risk from inappropriate administration of dextrose. We conducted a prospective trial to determine whether the blood glucose of 50 patients receiving CPR could be accurately assessed using a portable rapid-reagent device in the emergency department (ED). We analyzed both capillary and venous blood samples in the rapid-reagent system, using laboratory analysis of venous blood to define the patient's true blood glucose level. Capillary blood analysis identified 8 patients as hypoglycemic; only 3 of these patients were truly hypoglycemic, and 2 patients identified as hypoglycemic by fingerstick were actually hyperglycemic on laboratory analysis. The only instance in which a patient was classified differently by venous rapid-reagent and laboratory analysis occurred when a patient assessed as normoglycemic (169 mg/dL) by the laboratory had a venous rapid-reagent glucose reading of 182 mg/dL (hyperglycemic). We recommend that venous (rather than capillary) blood be used to analyze blood glucose in all patients receiving CPR before dextrose administration is considered.
引用
收藏
页码:1072 / 1075
页数:4
相关论文
共 11 条
[1]   FINGERSTICK GLUCOSE DETERMINATION IN SHOCK [J].
ATKIN, SH ;
DASMAHAPATRA, A ;
JAKER, MA ;
CHOROST, MI ;
REDDY, S .
ANNALS OF INTERNAL MEDICINE, 1991, 114 (12) :1020-1024
[2]   50-PERCENT DEXTROSE - ANTIDOTE OR TOXIN [J].
BROWNING, RG ;
OLSON, DW ;
STUEVEN, HA ;
MATEER, JR .
ANNALS OF EMERGENCY MEDICINE, 1990, 19 (06) :683-687
[3]   PROGNOSTIC-SIGNIFICANCE OF HYPERGLYCEMIA IN ACUTE STROKE [J].
CANDELISE, L ;
LANDI, G ;
ORAZIO, EN ;
BOCCARDI, E .
ARCHIVES OF NEUROLOGY, 1985, 42 (07) :661-663
[4]   A CLINICAL COMPARISON OF THE PERFORMANCE OF 4 BLOOD-GLUCOSE REAGENT STRIPS [J].
CHEELEY, RD ;
JOYCE, SM .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 1990, 8 (01) :11-15
[5]   THE EMPIRIC USE OF HYPERTONIC DEXTROSE IN PATIENTS WITH ALTERED MENTAL STATUS - A REAPPRAISAL [J].
HOFFMAN, JR ;
SCHRIGER, DL ;
VOTEY, SR ;
LUO, JS .
ANNALS OF EMERGENCY MEDICINE, 1992, 21 (01) :20-24
[6]  
HOGYA PT, 1989, PREHOSP DISASTER MED, V4, P109
[7]  
Jones Jonathan L., 1992, Journal of Emergency Medicine, V10, P679, DOI 10.1016/0736-4679(92)90524-W
[8]   A PROSPECTIVE EVALUATION OF GLUCOSE REAGENT TESTSTRIPS IN THE PREHOSPITAL SETTING [J].
LAVERY, RF ;
ALLEGRA, JR ;
CODY, RP ;
ZACHARIAS, D ;
SCHRECK, DM .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 1991, 9 (04) :304-308
[9]  
PLUM F, 1982, DIAGNOSIS STUPOR COM, P352
[10]   INCREASED DAMAGE AFTER ISCHEMIC STROKE IN PATIENTS WITH HYPERGLYCEMIA WITH OR WITHOUT ESTABLISHED DIABETES-MELLITUS [J].
PULSINELLI, WA ;
LEVY, DE ;
SIGSBEE, B ;
SCHERER, P ;
PLUM, F .
AMERICAN JOURNAL OF MEDICINE, 1983, 74 (04) :540-544