Diabetic care practices are often overlooked in EMS. Blood glucose testing can expose people to bloodborne viruses such as Hepatitis B, Hepatitis C Virus, and HIV when testing supplies and materials are used on multiple patients. Outbreaks of Hepatitis B infection associated with unsafe diabetes care have been identified with increasing regularity particularly is settings where individuals require assistance with monitoring their blood glucose levels and glucometers are used on multiple patients. EMS is one of these settings.
Here are some simple rules EMS providers should follow when testing blood glucose levels.
1. Use single-use lancets that permanently retract upon puncture. This adds an extra layer of safety for both the patient and you.
2. Dispose of used lancets at the point of use in an approved sharps container.
3. NEVER reuse lancets.
4. Clean and disinfected the blood glucose meter BEFORE and AFTER each use per the manufacturer’s instructions. This must be done to prevent the carry-over of blood and infectious agents. NOTE: If the manufacturer does not specify how the meter should be cleaned and disinfected then it should NOT be used on multiple patients.
5. Change your gloves between patients. Healthcare personnel should change gloves between patients, even if patient dedicated testing devices and single-use, self-disabling lancing devices are used.
Think about it….
When was the last time you cleaned and disinfected the blood glucose meter on your ambulance?
1. CDC Infection Prevention during Blood Glucose Monitoring and Insulin Administration
2. Diabetes & Viral Hepatitis: Important Information on Safe Diabetes Care (PDF Suitable for use as a poster.) http://www.oneandonlycampaign.org/sites/default/files/upload/pdf/Diabetes%20and%20Viral%20Hepatitis_Safe%20Care.pdf
3. Diabetes & Viral Hepatitis: Important Information on Safe Diabetes Care (VDH PowerPoint Slide) http://www.vdh.virginia.gov/.../sites/13/2016/03/SafeDiabetesCare.pptx
4. Letter to Manufacturers of Blood Glucose Monitoring Systems Listed With the FDA https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/InVitroDiagnostics/ucm227935.htm
5. Glucometry Waiver is Necessary for EMS, Tidewater Emergency Medical Services Council Inc.; http://tidewaterems.org/glucometry-waiver