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It would be helpful to know who assayed the blood glucose using the PoCT device, and whether it was a technique that allows visual reading as well as the meter display. Was the anomalous PoCT result a single occurrence, or repeatable? Dr Jonathan Kay On Monday, March 11, 2002, at 09:31 , Hogan, Tim wrote: > Which system was used to measure a. The finger prick glucose, b. The > urine > ketones? > Have seen no published evidence of hyperosmolar coma causing this > problem > since days of BM 1-44 stick. Has anyone else? > > Tim > At Basildon > > [log in to unmask] > > Dear list members > > A young man presented with coma having been previously > fit and well. The relatives gave a history of him > having abdominal pain and vomiting over the last two > days. At the A/E, he was found to be in hypovolaemic > shock with peripheral shutdown. Despite this, a finger > stick blood glucose was performed and the glucometer > reading was 7.6 mmol/L. A urine test showed 4+ glucose > but negative ketones. A venous blood sample was rushed > to the lab which showed a serum glucose of 84.1 mmol/L > and arterial blood gas sample showed severe metabolic > acidosis with pH of 6.9. His serum B-hydroxybutyrate > (BOHB)was > 12.0 mmol/L. The serum sodium was 152 > mmol/L, potassium 4.5 mmol/L, osmolality 430 mosm/L, > urea 34 mmol/L and creatinine 481 umol/L. This young > patient presented with unusual hyperosmolar DKA with > predominant production of BOHB that gave a negative > reaction with urine dip stick. Despite the glucometer > SOP warning against use of finger stick sample in > peripherally shut down patients, clinical staff seem > to be unaware of this caveat. > > Comments are welcome. > > Mohammad > > ===== > Dr. M A Al-Jubouri > Consultant Chemical Pathologist > ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/