Blood Glucose Testing - Clinical Skills OSCE - Diabetic Testing - Health Assessment - Dr Gill

Name: Blood Glucose Testing - Clinical Skills OSCE - Diabetic Testing - Health Assessment - Dr Gill
Uploaded: 2025-02-15T21:13:24.459Z
Duration: 6 min 36 s
Channel: Dr James Gill

Dr James Gill

17 Video Views·Feb 15, 2025 #clinicalskills #Diabetes #DrGill

Blood Glucose Testing - Clinical Skills OSCE - Dr Gill

Many patients are aware of their need to monitor their blood sugar levels. However beginning to measure your blood glucose, can be a challenging skill to learn, verse it is important that all healthcare professionals engaging with diabetic patients are able to explain this simple procedure

As a result, medical students are often tested in their Clinical Skill OSCEs with this relatively straightforward station.

One of the reasons this is a core Clinical skills station at medical school, is it tests both student's communication skills, but also their direct knowledge of this Clinical procedure - testing a patient's blood glucose as part of a health assessment

It should be highlighted, that in this video the patient did not have an alcohol wipe of a finger before the blood glucose measurement was taken. There is conflicting evidence, most notably from historical research that alcohol wipes may negatively affect the accuracy of blood sugar readings. There are more recent articles, that have argued there is no clinical significance to any change that may occur to the blood glucose due to using the alcohol swabs, but it is essential to highlight that clinical consensus is still lacking on this point

https://scholars.unh.edu/cgi/viewcontent.cgi?article=1340&context=honors

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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.

However during OSCE assessments. Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical evaluation - you should concentrate on THEIR marks schemes for your assessments.

The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.

Some people viewing this medical examination video may experience an ASMR effect

#clinicalskills #Diabetes #DrGill

You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - https://www.drfinlays.co.uk/services/video-consultation/

00:00 - Preparation for Blood Glucose Testing
01:02 - Demonstrating the Glucometer and Lancet Setup
02:37 - Blood Draw Technique
03:45 - Interpreting the Test Results
04:05 - Managing Low Blood Sugar Levels
04:46 - Managing High Blood Sugar Levels
05:41 - Conclusion and Safe Disposal of the Lancet

I believe you've just had a chat with our nurse, haven't you, with regard to the diabetes? Yes. And we're now going to start you on how to do finger prick blood glucose, is that correct? Yes, it is. So, have you ever done this before? No, I haven't, but I've seen people doing it. Okay, so we're just going to quickly run through that to start off with. Before we start though, could I get you to just pop outside and just wash your hands to make sure that there's nothing on your hands, so that way we can ensure that we've got a good test, if that's okay? Okay. I'll get my kit ready whilst you just pop out. Just pop back in when you're ready, okay? Okay, thank you. Okay, so this is the same kit that you're going to be using at home. So this is the glucometer, and we've got a lancet, which you'll take the end off and you'll put it into the pen. Be careful at this point, and you'll be able to put the top on, like so, and then on the top you'll see a gauge here. The lower the gauge, the less deep it'll go. The longer the gauge, the deeper it'll go in. So, we'll start with the middle for the moment. Hopefully that should mean that we are able to get an effective blood draw. In order to fire it, we'll pull back on the plunger, and then we'll just press that button. That flash means it should have fired. When we pull up, you can see the yellow to show that everything is primed. So, as we do that, you'll get a small dot of blood, which we'll then put onto the test strip here, and that will give us our number. So, I'm just going to put my gloves on. Now, when you do these at home, it's vitally important to make sure you do wash your hands. Because if, for example, there's some sugar or anything like that on your fingers, then that can adversely affect this. OK, so we're going to open up the test strip, and we're going to put its electronic side in. It should wake everything up. OK, and we'll wait for that to start to say it's ready. OK, so we can see that it's ready to accept the blood. So, are you right or left-handed? I'm right-handed. OK, so let's start off with your left hand, if that's OK. And if we can just have your hand upwards like so. So, what we'll do is we'll go into the left side of your finger there, and it's vitally important to make sure that you don't take blood directly over the fingertip, because that's where all the sensitive parts of your finger are. And whilst a single shot won't cause a problem, over time that may actually cause damage to the skin and the nerves, which we don't want. So, again, we've got the needle in, we've got it set to 4 at the moment, and we've got the prime set. We're aware that the machine is still on, we've got the correct date and time, and it's asking for us to put the blood on. So, if you could just move your finger round. Super, thank you. So, we're just going to fire on the outside of your finger. So, 1, 2, 3, fire. OK, so we've got a little bit of blood there. That's good. I'm just going to go 1, 2, 3. Super. And if we just get you to hold on to that, that should stop nicely. OK, so we've got 5.6. So, that scores fine. So, we'll take that off. So, at the moment, that's excellent. So, whilst we do have that diabetes that we're worried about, we do know that at the minute that number is excellent. OK. So, did the nurse tell you about any of the blood sugar numbers that would be problematic? Below 4 is on the floor. Absolutely. So, if you were feeling a little bit unwell and you found a blood sugar of 4, what would you do at that point? I'd try and get some food into me, preferably things like orange juice or Lucozade or something. I could also make sure that I've got someone near me for help. Absolutely. So, one of the things I like to advise patients is if they keep a packet of Jelly Babies in their bag because it's a nice bit of sugar, honestly, they're probably not going to go off. OK. So, that's on the bottom side if we're having a hypo. Did they tell you what to do if things are going the other way, if they're high numbers? So, it'll be insulin injections maybe, but I know that if they get too high, I need to maybe consider going to hospital. OK. Well, thankfully we're not talking about insulin with yourself at the minute. What are the high numbers that we might worry about? Did she discuss that with you? I've got two numbers in my head. It's either above 7 or above 11. OK. So, absolutely. If it's above 11, then we need to think maybe we need to look at better control of your diabetes. If it's over 15, at that point we're causing damage. And if it's saying high or it's over 20, I really need you to contact us so we can see what we can do to help there and there. OK. Do you have any other questions for me at the moment? No. Super. OK. So, just to finally wrap up, when you've finished with the pen, again, you're going to take it apart and we're going to take the Sharp and make sure we put that into the Sharp's bin, which will make sure we get one prescribed for you. OK. Any other questions of that? No. Super. Well, have a good day and thank you for popping in. You too. Thank you.