Date Published
September 11, 2017
Updated For
ALS PCS Version ALS PCS Version 5.2
Question:
Question: In a situation where we are unable to get a blood glucose reading from the patient's finger due to patient being combative/handcuffed, are we allowed to get it from the toes of the patient?
Answer:
The situation you describe would be an exceedingly rare occurrence where toes of the patient would be accessible, but the fingers were not. If your safety is in jeopardy and a glucose cannot be obtained, then document as such with consideration of a patch to the BHP for some shared decision making on how to proceed. The concern lies with taking a capillary sample from the toes in a patient with diabetes or peripheral vascular disease. These patients often have very poor blood circulation to the distal extremities and impaired wound healing. A cap sample taken in the toes may result in a wound that becomes chronic with the potential for amputation down the road. Many patients with DM and PVD have sustained trivial foot wounds that result in this outcome, so avoiding a capillary sample in the toes is warranted.
Categories
Keywords
blood sugar
Additional Resources
No additional resources are available for this SWORBHP Tip.