Does Site Matter? Comparing Accuracy and Patient Comfort of Blood Glucose Samples Taken From the Finger and Palm of the Perioperative Patient.

PURPOSE: This study compared two blood glucose (BG) point of care sampling methods to determine which is least painful yet accurate. DESIGN: The two-period, two-treatment crossover trial compared the traditional fingertip sampling method to a form of alternative site testing (AST), palm of the hand. METHODS: Subjects received both methods of BG sampling to compare comfort and accuracy. They were randomly assigned to determine which method was used first. Pain rating (0 to 10) and glucose results for both methods were documented. FINDING: Results indicated that pain rating was significantly lower with AST (1.65) than with the standard site (2.83) (P < .001). There was no significant difference in mean glucose measurements between standard care (150 mg/dL) and AST (149 mg/dL). The numbers were closely correlated (r = 0.9815). CONCLUSIONS: Findings support AST via the palm of the hand as an accurate and less painful method of obtaining BG results on diabetic patients.

The Optimal Time and Method for Surgical Prewarming: A Comprehensive Review of the Literature.

PURPOSE: Inadvertent hypothermia is a common problem in the operating room. This can contribute to many unfavorable outcomes --rising costs, increased complications, and higher morbidity rates. DESIGN: This review determined the optimal method and time to prewarm a surgical patient to prevent perioperative hypothermia. METHODS: CINAHL and PubMed were searched. Fourteen articles were ultimately included in this review. FINDINGS: Based on the literature reviewed, it was suggested that forced-air warming was most effective in preventing perioperative hypothermia. Eighty-one percent of the experimental studies reviewed found that there was a significantly higher temperature throughout surgery and in the postanesthesia care unit for patients who received forced-air prewarming. CONCLUSIONS: Thirty minutes was found to be the average suggested amount of time for prewarming among the literature; however, a minimum of 10 minutes of prewarming was suggested to significantly reduce rates of hypothermia in perioperative patients and decrease the adverse effects of hypothermia.

What is the least painful method of anesthetizing a peripheral IV site?

The placement of an intravenous (IV) catheter for the administration of fluids, blood products, and medications is a common intervention for surgical procedures and perianesthesia patients. Although the placement of a peripheral IV may be routine for perianesthesia nurses, it is important to address the patient's level of pain related to the procedure. One technique to diminish the discomfort associated with the IV insertion is anesthetizing the site. The purpose of this study was to compare three methods for anesthetizing peripheral IV catheter sites before insertion to determine which method provides optimal patient comfort during the anesthetizing and IV catheter insertion process. The findings demonstrate that there was no statistical difference in pain when anesthetizing the site using the three methods. However, there was a difference with the IV insertion process. Using 1% lidocaine resulted in the least painful IV insertion.