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Chinese home first aid for stroke

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Very Good Morning Brahmanyan sir, Yes sir I received this as a forward mail a couple of weeks ago.,sir one thing we have to be clear to know certain things that are very vital for all. this STROKE condition occur mainly due to disturbance / block to the higher centers -brain . afall /faint can occur due to many conditions due to origin ,but to find the proper diagonisis and eventually implication of treatment is very crucial. a victim due to STROKE ,can be asked to elicit few actions ,there by the rush for treatment is done at once ,here TIME is the vital factor ,when delayed can result in medical emergency,permanent damages. the victim /person can be asked 1. to rise the arm/arms 2. to smile 3.to attempt to speak /talk few words 4.to attempt few steps to walk. these few steps can very easily assist , identify the true picture as a person when being attack by stroke cannot elicit proper smile ,the affected side on face get deviated ,cannot talk ,pronounce few words ,leads to slurred speech ,he / she cannot move his/ her arms ,legs to elicit the action of walk ,raising the arms of the affected site. so these take only few minutes to know the picture of patient ,and at once has to be taken to the hospital for the proper treatment ,as first hand line of treatment ASPIRIN has to be given .hope that one knows the value of time and people.

Dear Doctor,
Very Good morning.
Thanks and thanks a lot for the valuable information.
Warm Regards,
Brahmanyan,
Bangalore.
 
Hello Brahmanyan sir , knowledge is to be shared. since its a medical condition ,awareness is very crucial.thanks for your concern.
 
Dr. Narayani,
Thanks for bringing some sense to this topic.
I want people to look at the following site for additional comment on this topic from the medical professional.

NeuroLogica Blog » Needle Nonsense for Stroke

Like most medical advice dispensed in the form of a chain e-mail message, it has no scientific basis. In fact, following its advice can do harm.


Forcing a stroke victim to sit up is never a good idea, because it can cause a drop in blood pressure, says Dr. Larry B. Goldstein, director of the Duke Stroke Center.


It would be better to help the person lie down.


Pricking the victim’s finger is also a bad idea, not only because it is futile, but because doing so can delay medical treatment, which is the only thing that can help.


THE BOTTOM LINE Only emergency medical treatment can help a stroke victim.

http://www.nytimes.com/2006/11/21/health/21real.html

Bloodletting (or blood-letting) is the withdrawal of often little quantities of blood from a patient to cure or prevent illness and disease. Bloodletting was based on an ancient system of medicine in which blood and other bodily fluid were considered to be "humors" the proper balance of which maintained health. It was the most common medical practice performed by doctors from antiquity up to the late 19th century, a time span of almost 2,000 years. The practice has now been abandoned for all except a few very specific conditions. It is conceivable that historically, in the absence of other treatments for hypertension, bloodletting could sometimes have had a beneficial effect in temporarily reducing blood pressure by a reduction in blood volume. However, since hypertension is very often asymptomatic and thus undiagnosable without modern methods, this effect was unintentional. In the overwhelming majority of cases, the historical use of bloodletting was harmful to patients.

 
You are right. You use tiny lancets which are commercially available in sterile package. As an extra precaution you should wipe the area of the finger with an alcohol swab (to prevent any surface contamination from entering the blood stream) and wipe off the blood and clean the surface with the same swab after the sample has been drawn into glucose strip to prevent any further infection.

Sri. Mahakavi, Greetings.

Alcohol swabs should not be used before pricking the finger tips for checking Blood Glucose Level ( BGL). Should be washed only with plain water. The sugar content in the alcohol swab will always show an higher BGL. The biggest risk in that is, administering extra insulin than required if that person is on a sliding scale insulin dosage due to the error in reading the BGL value.

Cheers!
 
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Wow!! One day I was not in forum and so much I missed.
Today the conference I attended had lots of info on stroke.

I should have brought my lap top logged in to TB forum and asked the Consultant there for his opinion about some "very interesting" facts here.

Dr Narayani,Raghy and Prasad and Brahmanyan ji....take good care of this thread till I am back from day 2 of the conference tomorrow.

I am sure you guys get what I mean!!LOL

Note: I would not want to discredit any form of alternative medicine but its just that stroke isn't all about Bleeding and Burst vessels alone.
Aspirin is also only given in Ischeamic Strokes(now there are newer anti clotting agents).
Aspirin is NOT given for Strokes caused by Intracranial Bleed.

Ok would like to share this with you guys:

The Neurologist who gave a lecture today was saying NOT to take Giddiness lightly.
He said there are cases of Ischeamic Stroke which only present with sudden onset of giddiness and nothing else.
Patient could be walking around normally and talking normally.

The neurologist also mentioned if patient is having other risk factors like Hypertension and Diabetes consider doing a MRI brain if giddiness is sudden in onset so that we DO NOT miss out a subclinical stroke.

So do not take giddiness too lightly.
These days lots of diseases are having atypical presentations.
 
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Wow!! One day I was not in forum and so much I missed.
Today the conference I attended had lots of info on stroke.

I should have brought my lap top logged in to TB forum and asked the Consultant there for his opinion about some "very interesting" facts here.

Dr Narayani,Raghy and Prasad and Brahmanyan ji....take good care of this thread till I am back from day 2 of the conference tomorrow.

I am sure you guys get what I mean!!LOL

Note: I would not want to discredit any form of alternative medicine but its just that stroke isn't all about Bleeding and Burst vessels alone.
Aspirin is also only given in Ischeamic Strokes(now there are newer anti clotting agents).
Aspirin is NOT given for Strokes caused by Intracranial Bleed.

Ok would like to share this with you guys:

The Neurologist who gave a lecture today was saying NOT to take Giddiness lightly.
He said there are cases of Ischeamic Stroke which only present with sudden onset of giddiness and nothing else.
Patient could be walking around normally and talking normally.

The neurologist also mentioned if patient is having other risk factors like Hypertension and Diabetes consider doing a MRI brain if giddiness is sudden in onset so that we DO NOT miss out a subclinical stroke.

So do not take giddiness too lightly.
These days lots of diseases are having atypical presentations.

We miss you, and your wise counsel.

King Solomon wrote, "Listen to wise advice; follow it closely, for it will do you good, and you can pass it on to others".
 
Hello Brahmanyan sir , knowledge is to be shared. since its a medical condition ,awareness is very crucial.thanks for your concern.

Dear Doctor,

True , your words echo that of my cousin Dr.H.Srinivasan, who believed ."The goal of science is to add to knowledge, that is to improve our understanding of some aspect of the world around us and for that purpose, like money, knowledge must also be spread”. I have written his Biography in my Blog URL of which is given hereunder:
Biography
Also time permits I would like you to read his "Dr.Venkataswamy Oration ", which will give an idea about this Doctor:
https://tspace.library.utoronto.ca/b.../1/pl04002.pdf
Mrs. Visalakshi Ramani has posted this biography in six parts (#480 to #485) under her famous thread " From Adam to Zeus....through all men and Gods"(#59) in "Tamil Brahmins Forum"

Regards,
Brahmanyan,
Bangalore.

 
Sri. Mahakavi, Greetings.

Alcohol swabs should not be used before pricking the finger tips for checking Blood Glucose Level ( BGL). Should be washed only with plain water. The sugar content in the alcohol swab will always show an higher BGL. The biggest risk in that is, administering extra insulin than required if that person is on a sliding scale insulin dosage due to the error in reading the BGL value.

Cheers!

By alcohol swabs I mean those that are clinical products such as sold in a pharmacy in individual sealed packs. They are not "alcohol" --the one you consume. It is a synthetic swatch soaked in isopropyl alcohol sealed in a paper pouch whose inside is aluminized. It is the recommended procedure for skin prick to test bloood glucose. The other procedure is soap and water which is a cumbersome procedure. The swab does not have any sugar/glucose. Even absolute ethanol (95% ethanol--5% water) does not have any glucose in it. But as I said you can use the alcohol swabs sold in the pharmacy without any problem. Ask your pharmacist. Don't soak your finger in beer though, before pricking it!!!!!!!!!!!!!!!!
 
Is Dr. James Crawford a layman?

Dr. Crawford is a scientist with a fifty year history of biomedical research.

Originally the term "layman" was used to describe anybody outside of clergy. Let us not get into that.

Webster defines layman as : a person who is not a member of a given profession, as law or medicine.

There you go. Biomedical research is not "medicine". A bio-medical scientist cannot practice medicine or be a member of the American Medical Association.
 
Anybody can define a word as they want to suit their fancy.
There are standard definition which is accepted by the world.


A layman can not detect a stroke. An EMT person may hypothesis a stroke and act accordingly. The Emergency room physician after diagnosis and scans may come to a preliminary diagnosis of stroke. The radiologist will confirm the diagnosis after full study. The doctor treating him may treat for the stroke.

Read my post #20. I said a layman can "recognize" a stroke by the symptoms I described. It can be a wrong diagnosis. So is the heartburn ( a misnomer,, used even by physicians) to describe acid reflux problem. For that matter in many disease cases even doctors cannot detect nor know what causes it. The latter case diseases are called "idiopathic".

There is a difference between "recognize' and "detect".
 
Half knowledge is worse than ignorance « Confessions of an Innovative Mind
Half knowledge is worse than ignorance.

But pretention of knowing a knowledge field, just because I can spell that field is even worse.
I do not have a PHD, I am only an engineer.
In a scientific study you have to have proof of occurrence of repeatable events with similar results. There is TV show in USA, called Mythe busters. The routinely take up urban legends and chaine-mail topics and show how wrong they are.
 
Sowbagyavathy Renuka , Greetings.

The Neurologist who gave a lecture today was saying NOT to take Giddiness lightly.
He said there are cases of Ischeamic Stroke which only present with sudden onset of giddiness and nothing else.
Patient could be walking around normally and talking normally.

I thought giddiness along with a very brief period of backout was the indication for stroke. Persons with primary high blood pressue are susceptible to this, aren't they?

I have primary high blood pressure. Such blood pressures are not secondary to some other issues; so, quite hard to treat ( that is, there is no cure now). Few years back, I used to get giddiness and a brief period of blackout ( up to 3 seconds). ( due to the blackout, I used to loose my balance too). Every blackout was a mini-stroke! ( But I won't die of cardiac condition!... I will die of choking! Recently I choked at work... It was quite nasty. The trouble is, if I choke on nothing, there can't be much of first aid available for that!).

Usuually high blood pressure condition is coupled with head ache. Severe head ache and restlessness. My BP has gone up to 180/130 mmHg. When I gave up smoking, my BP was all over the place. i did have brief periods of chest pain too. I dismissed them as 'heart burns'. Heart burns and Chest pain have very similar symptoms. I did have chest pain at those times when I gave up smoking; I found out in detail much later. Only once my BP was 190/140 mmHg; That was the only time I was slightly scared and immediately took 100mg of asprin. ( I am on regular medications. But sometimes I don't want to take them!).

But for some reason, in India, I found high BP, causes more discomfort. While I was in Bangalore in February, I was actually down with giddiness, inspite of taking my medications regularly! I don't know why though. But here in Brisbane, I could skip those tablets for 2 to 3 days in a row and still nothing happens! Also, I am more active here too!

What ever the case may be, it is better to avoid the siyuation of stroke in the first place.

stroke = High blood pressure + more salt in diet. ( It is very simple; more salt in the system retains more fluid in the system there by increasing pressure)
Stroke = poor venous return and fluid build up. (Exercise, lot of walking improves the venous return).
Stroke = alcohol intake. Alcohol increases the BP. ( Don't know the mechanics of that).

Improvement in life style, regular exercise ( better to walk in your own home. roads are that polluted anyway. Plus the traffic), less salt intake....and regular medical check up would help reduce the stroke possibilities.

Cheers!
 
By alcohol swabs I mean those that are clinical products such as sold in a pharmacy in individual sealed packs. They are not "alcohol" --the one you consume. It is a synthetic swatch soaked in isopropyl alcohol sealed in a paper pouch whose inside is aluminized. It is the recommended procedure for skin prick to test bloood glucose. The other procedure is soap and water which is a cumbersome procedure. The swab does not have any sugar/glucose. Even absolute ethanol (95% ethanol--5% water) does not have any glucose in it. But as I said you can use the alcohol swabs sold in the pharmacy without any problem. Ask your pharmacist. Don't soak your finger in beer though, before pricking it!!!!!!!!!!!!!!!!

Sri. Mahakavi, Greetings.

I am a qualified Registered Nurse. I know the effects of alcowipe swabs. Also I have observed the small increase in BGL readings. In the aged care settings, I used to be person inchage of hypo-glycemia managing person atleast 5 times in the past 2 years. I am not interested in debating with you. I am sorry. If I am seen using alcowipe before checking BGL, I can land in hot waters! No, thanks!

Cheers!
 
Sri. Mahakavi, Greetings.

I am a qualified Registered Nurse. I know the effects of alcowipe swabs. Also I have observed the small increase in BGL readings. In the aged care settings, I used to be person inchage of hypo-glycemia managing person atleast 5 times in the past 2 years. I am not interested in debating with you. I am sorry. If I am seen using alcowipe before checking BGL, I can land in hot waters! No, thanks!

Cheers!

Mr. Mahakavi ji,
I am going to Take cue from Mr Raghy,
I am not interested in debating with you.
 
Sri. Mahakavi, Greetings.

I am a qualified Registered Nurse. I know the effects of alcowipe swabs. Also I have observed the small increase in BGL readings. In the aged care settings, I used to be person inchage of hypo-glycemia managing person atleast 5 times in the past 2 years. I am not interested in debating with you. I am sorry. If I am seen using alcowipe before checking BGL, I can land in hot waters! No, thanks!

Cheers!

I don't know what you mean by "small increases in BGL readings". What do you mean by "small"? If you are using a blood glucose meter to measure the glucose in blood repeatedly you will get different readings. A reading of 120 can change to 115 or 125 if you repeat the measurements one after the other. It has nothing to do with wiping with alcohol swabs or not. I repeat, alcohol swabs have no glucose. Alcohols are products obtained from distillation after the products are manufactured. Even absolute ethanol (95% ethanol-5 % water) which is obtained from fermentation liquor by extensive distillation does not contain any sugar. Reason: sugar is a solid and stays back when the alcohol is distilled ( for sugar to come with alcohol as a byproduct it is has to melt first and then boil---sugar has a much higher boiling point---so no chance of sugar going with the alcohol). Isopropyl alcohol (also called rubbing alcohol) which is used in the alcohol swabs is prepared by reacting water with a hydrocarbon called propene. No contact with sugar containing materials at any time. I wonder which hospital is prohibiting you from using the clinical rubbing alcohol swabs while testing blood glucose using finger pricks.
 
Half knowledge is worse than ignorance « Confessions of an Innovative Mind
Half knowledge is worse than ignorance.

But pretention of knowing a knowledge field, just because I can spell that field is even worse.
I do not have a PHD, I am only an engineer.
In a scientific study you have to have proof of occurrence of repeatable events with similar results. There is TV show in USA, called Mythe busters. The routinely take up urban legends and chaine-mail topics and show how wrong they are.

I think it is time that everybody who posts a comment here should go back and read the post #1 again.
The chinese person says to do the finger pricking as a FIRST AID. He/She even mentioned that he/she transported the person to the hospital after he regained his consciousness after the finger prick treatment. The only error in her message is the statement about burst capillaries in the brain. That is a diagnosis nobody can make without a brain scan. I detailed 3 kinds of stroke in my post. If it is a hemorrhagic stroke finger pricking is not going to help. But in the absence of knowing the cause (to be done only in the ER setting of the hospital) the first aid cannot do any harm while you have already called the 911 (ambulance) and waiting for its arrival twiddling your thumbs.

Agreed that she made that erroneous statement. The so-called finger pricks do not BLEED the person to death. These are small drops building up at the finger tips and they will not flow forever. The clotting process will stop any profuse bleeding. The sitting posture she suggested was a transition from a standing one (to stabilize the victim), not from a lying posture to a sitting one.

Instead of proclaiming finger prick will do harm, there should be clinical evidence that it does so. Otherwise it is all hogwash. If only that treatment is the final treatment without getting to a hospital quickly then it is bad.

As for ambulances, many times if you wait for it in remote areas or in developing countries you never know how long will it be before the ambulance comes to your place. By then the victim might be dead in some cases.
 
Half knowledge is worse than ignorance « Confessions of an Innovative Mind
Half knowledge is worse than ignorance.

But pretention of knowing a knowledge field, just because I can spell that field is even worse.
I do not have a PHD, I am only an engineer.
In a scientific study you have to have proof of occurrence of repeatable events with similar results. There is TV show in USA, called Mythe busters. The routinely take up urban legends and chaine-mail topics and show how wrong they are.


A clarification is needed here. NOBODY claims that the first aid treatment is a scientific study. It is a little more than a home remedy. It is similar to giving a person crying in pain with a bloated stomach (obviously gas pain) with a charcoal capsule and a glass of water to absorb the gas in the stomach prior to transporting that person to the hospital.

It (the finger pricking first aid) probably was found effective in one particular setting without any scientific basis. To validate it it has to be tried in a few places. If skepticism prevails even before taking it up the study cannot be done. By the way in a clinical study comparing a drug against a placebo, some deaths occur with a drug. Does it prevent the companies from conducting such studies? Are they held responsible for such deaths? All that I am giving is an explanation and a nod of approval to try it as a FIRST AID to be followed with the trip to the ER.

Knowing how to spell is the first step to start learning. But misspelling (e.g., pretention ​ instead of pretension) or closing one's mind is worse than ignorance. It has another name which I will not go into.
 
I don't know what you mean by "small increases in BGL readings". What do you mean by "small"? If you are using a blood glucose meter to measure the glucose in blood repeatedly you will get different readings. A reading of 120 can change to 115 or 125 if you repeat the measurements one after the other. It has nothing to do with wiping with alcohol swabs or not. I repeat, alcohol swabs have no glucose. Alcohols are products obtained from distillation after the products are manufactured. Even absolute ethanol (95% ethanol-5 % water) which is obtained from fermentation liquor by extensive distillation does not contain any sugar. Reason: sugar is a solid and stays back when the alcohol is distilled ( for sugar to come with alcohol as a byproduct it is has to melt first and then boil---sugar has a much higher boiling point---so no chance of sugar going with the alcohol). Isopropyl alcohol (also called rubbing alcohol) which is used in the alcohol swabs is prepared by reacting water with a hydrocarbon called propene. No contact with sugar containing materials at any time. I wonder which hospital is prohibiting you from using the clinical rubbing alcohol swabs while testing blood glucose using finger pricks.

Sri. Mahakavi, Greetings.

I amnot familiar with the BGL reading mentioned by you. In Australia, glucose present in mmol/L of blood is used to measure BGL readings. According to mmol/L, when glucose levels are between 1.0 and 4.0 mmol/l, it is considered 'hypotensive' and depending upon the persons presentation, emergency assistance may be sought. There is a strict protol to be observed and should be documented on line at the earliest instance.
BGL readings between 4.0 and 6.0 are okay, provided the person can and would eat something; to be monitored closely though.
BGL readings between 6.0 and 12.0 are considered okay. All measurements are before meals.

Any person on diabetic management with any fast acting insulin would be on a sliding scale insulin dosage. ( like up to 10.0mmol/L - say 6 units of Novarapid or Actrapid or whatever the rapid is prescribed; then the dosage would increase .... like add 2 units if BGL reading between 10.0 and 15.0; or add 3 to 5 units, whatever the case may be for BGL readings between 15.0 and 20.0 mmol/L. So, if I get an error inmeasurement, I would end up giving the extra insulin or may give less insulin.Once I didn't trust my own measurements, repeated twice, got a nurse all the way across the facility to check the BGL. It turned out, he stole one roast chicken from the shopping centre nearby and ate the whole lot! He was too scared to inform me! So, his BGL, as per my information, before dinner was high as a kite!).

Although I was not interested in debating with you, I do see your point anyway. I am presenting a discussion for you in the same subjeect......

Fingerstick Glucose Testing-Do Alcohol Wipes Interfere w/ Results?

Cheers!

P.S - If the person is suffering from diarrohea, kindly watch it. BGL will drop like a stone. I would monitor BGL every two hours; if required, even more frequently.
While talking about diarrohea, oral contraceptive for female does not work if she suffers from diarrohea. I don't know about males!
 
Sri. Mahakavi, Greetings.

I amnot familiar with the BGL reading mentioned by you. In Australia, glucose present in mmol/L of blood is used to measure BGL readings. According to mmol/L, when glucose levels are between 1.0 and 4.0 mmol/l, it is considered 'hypotensive' and depending upon the persons presentation, emergency assistance may be sought. There is a strict protol to be observed and should be documented on line at the earliest instance.
BGL readings between 4.0 and 6.0 are okay, provided the person can and would eat something; to be monitored closely though.
BGL readings between 6.0 and 12.0 are considered okay. All measurements are before meals.

Any person on diabetic management with any fast acting insulin would be on a sliding scale insulin dosage. ( like up to 10.0mmol/L - say 6 units of Novarapid or Actrapid or whatever the rapid is prescribed; then the dosage would increase .... like add 2 units if BGL reading between 10.0 and 15.0; or add 3 to 5 units, whatever the case may be for BGL readings between 15.0 and 20.0 mmol/L. So, if I get an error inmeasurement, I would end up giving the extra insulin or may give less insulin.Once I didn't trust my own measurements, repeated twice, got a nurse all the way across the facility to check the BGL. It turned out, he stole one roast chicken from the shopping centre nearby and ate the whole lot! He was too scared to inform me! So, his BGL, as per my information, before dinner was high as a kite!).

Although I was not interested in debating with you, I do see your point anyway. I am presenting a discussion for you in the same subjeect......

Fingerstick Glucose Testing-Do Alcohol Wipes Interfere w/ Results?

Cheers!

P.S - If the person is suffering from diarrohea, kindly watch it. BGL will drop like a stone. I would monitor BGL every two hours; if required, even more frequently.
While talking about diarrohea, oral contraceptive for female does not work if she suffers from diarrohea. I don't know about males!

Raghy:
I am glad you are still corresponding. This gives me the opportunity to dispel your misgivings about alcohol wipes and their supposed false readings for you. I am also glad that that you provided me the website of allnurses.com wherein the question of using alcohol wipes has elicited so many responses. I have read a few of them and I will get back to you in an hour or so with a summary of all responses and my own scientific analysis (trust me, I am chemist, biochemist, and biotechnologist researcher who has also worked in the area of diabetes). Pl read by blogposts at this site on diabetes drugs and the future posts on insulin usage. I will get back here in an hour or two. It is dinner time where I am. Thank you.
 
Raghy:
I am glad you are still corresponding. This gives me the opportunity to dispel your misgivings about alcohol wipes and their supposed false readings for you. I am also glad that that you provided me the website of allnurses.com wherein the question of using alcohol wipes has elicited so many responses. I have read a few of them and I will get back to you in an hour or so with a summary of all responses and my own scientific analysis (trust me, I am chemist, biochemist, and biotechnologist researcher who has also worked in the area of diabetes). Pl read by blogposts at this site on diabetes drugs and the future posts on insulin usage. I will get back here in an hour or two. It is dinner time where I am. Thank you.

Sri. Mahakavi, Greetings.

I respect your opinions. But my practice is not for debate. I am bound by procedures and protocols. Yes, alcowipes were used in the past; not anymore. Across Queensland/ Australia, the use of alcowipes are discouraged. Mainly, the system works under 'dischage plan' which is kicked off on the day of admission. The affected person is expected to look after himself/herself at home. So, cleaning well with normal water is demonstrated and encouraged so that, the affected person can do it at home. I look after one lady with reduced mental health in a rehabilitation setting. She measures her own BGL twice a day. I would do random checks to make sure she does the test. She doesn't use alcowipes. Just plain water.

Since I am bound by health policies and protocols, any debate would be an empty debate. I am not keen to prove any point. I am only a nurse. I am not a chemist. So, naturally my knowledge would be quite restricted in those areas.

Cheers!
 
Sri. Mahakavi, Greetings.

I respect your opinions. But my practice is not for debate. I am bound by procedures and protocols. Yes, alcowipes were used in the past; not anymore. Across Queensland/ Australia, the use of alcowipes are discouraged. Mainly, the system works under 'dischage plan' which is kicked off on the day of admission. The affected person is expected to look after himself/herself at home. So, cleaning well with normal water is demonstrated and encouraged so that, the affected person can do it at home. I look after one lady with reduced mental health in a rehabilitation setting. She measures her own BGL twice a day. I would do random checks to make sure she does the test. She doesn't use alcowipes. Just plain water.

Since I am bound by health policies and protocols, any debate would be an empty debate. I am not keen to prove any point. I am only a nurse. I am not a chemist. So, naturally my knowledge would be quite restricted in those areas.

Cheers!

OK, I am back. Now that I know you are in Queensland, I will talk your language. I am not here to encourage you to use alcohol wipes if your institution/supervisors prohibit you from using it. They probably came to this conclusion because of non-standard method adopted by each technician of using alcohol wipes to clean. The soap and water method, as I said is fine except you don't know if the patient who does the testing himself/herself religiously follows the cleaning regimen. Besides, after washing if they wipe it dry with a dirty cloth that introduces a possibility of infection. Sometimes they may skim the soap/water process. I am not going to dwell on that. The alcohol wipe is the quickest, cleanest, and surest method, if done right. The rest of my post is only for your education. It is not meant to encourage you to use the alcohol wipes, OK? To simplify the explanation broken into parts, I will take one issue at a time. So follow the following posts one at a time.
 
Now to make the numbers used in the US and rest of the world equivalent.
As you know the diabetes testing supplies market is the largest in the US almost as much as the rest of the world, partly because there are 20 million+ diabetics in the US and partly because on average they test a minimum of 3 times a day. If a European manufacturer of glucose meters/strips/ lancets etc., wants to sell in the US they have to use the numbers that are recognized in the US. The US is an 800 pound guerilla and hence has to be catered to on its own terms.

The molecular weight of glucose is 180 g. Accordingly 1 mol/L will have 180 g/L; 1 mmol/L will have 180 mg/L of the sample, be it water, or blood. In the US the unit used is mg/deciliter. That means your 1mmol/L (180 mg/L) will translate to 18 mg/deciliter or simply the number will be 18.

When you say your before meals BGL as:
1-4 mmol/L it means (in the US) 18-72 mg/deciliter. 4 mmol/L is not bad (just on the edge of hypoglycemic) when you measure before meals although ideally it should be between 5 and 7.(We say in the US between 90 and 120). In the US anything between 8 and 12 before meals is considered high. Between 8 and 10 is normal post-prandial (1-2 hours after a meal). Anything over 12 (postprandial) is on the higher side. It may not cause a crisis for the patient but over the long term if the trend continues it may be deleterious.

If your average BGL over the course of a day is 10 mmol/L the hemoglobin A1c will be 8.0 % which is not advisable to have over the long term since the damage to vascular, and neuro systems will start. If your patients are already very obese and are having some of these problems it is advisable to bring the numbers down drastically so that the average number over a 24-hour period is brought to 10 mmol/L or below.

If the before meals numbers are consistently 15-20 you have a serious problem for the patient. Even 10-15 is on the high side. The patient will be a candidate for vascular, kidney, vision, and neuro problems down the road.

All the above is meant to educate. If your hospital system advises differently so be it. I am only educating you here, not to change your practice contrary to what your system is enforcing.
 
Regarding your patient who measured a high BGL (after stealing and eating a chicken in the next-door restaurant), chicken alone will not raise the glucose enormously high. He must have supplemented with a liberal dose of mashed potato and/or a double cone icecream.
 
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Raghy:
Again to reiterate that using alcohol wipe to clean will not raise BGL. Alcohol that is used in the wipes is isopropyl alcohol. It does not have even a trace of glucose.
Sometimes a low value is possible because if you wipe and not let it dry completely, a thin film of alcohol will be left on the surface of the skin and when the prick is made and you squeeze a drop of blood (say a few microliters) the thin film of alcohol will dilute the blood drop and accordingly decrease the glucose present in the blood ( the same amount of sugar but a larger volume due to slight contamination of alcohol). So the proper way to do it is:

Use the wipe to smear the area of the finger, wave the finger in the air for a couple of seconds so that the alcohol evaporates (it will because alcohol has a high vapor pressure even at room temperature) and then do the prick. One could blow on the finger to make it evaporate faster but it is not hygienic. Blowing will not increase the BGL but the bacteria from your breath might contaminate the blood stream in your body through the ruptured area. Then again, unless you have a serious infection it will bot be a problem. You have millions and millions of bacteria in your oral cavity which are not pathogenic unless you are sick with some infection. If that be the case you can have blood poisoning.
 
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