Inadequate Blood Sample

[loretta]

Has any one had a problem getting enough blood from their finger for the Inratio strip? I soak my hand, rub my fingers, squeeze the tips & still have a problem. Today I wasted 3 Inratio strips, came up error & I knew it would because the blood drop was too small. The lancets QAS send me are gauge 21 & the last ones were 23. Still the same problem. I put the dial on # 5 so it will go in deeper. I test every week. At least twice a month I have to use 2 strips. Any suggestions?

 

[Ross]

Are you running your hands under warm water then trying to test? Usually that works pretty well. Where at on your finger are you poking? The INRatio takes very little blood to test, so I'm trying to figure out what your not doing to get that small amount of blood.

 

[Eva]

Have you tried to drink a glass of water or more about 15 minutes before testing?! I know this is essential to draw blood from vein, but it could work here too

 

[catwoman]

Loretta:

I have had that error message once with my INRatio. Since then, I focus on getting the equivalent of 2-3 big drops of blood hanging off my finger for the blood sample.

I use 21 gauge needles for my little lancing device and buy them at a Walgreen's drugstore. Very inexpensive & work great. I set it on 5.

 

[cirrider]

Besides the other suggestions, I have used a small rubber band on the end of the finger that I am going to test. When I put the strip into my Coaguchek XS it starts its countdown. I then put the rubber band on just above the 1st knuckle. Kind of makes the tip of the finger swell up. Since I have been doing that, I have never failed to get enough blood for the test. Just passing on what someone else shared with me. Hope it helps.

 

[JLant]

Hi Loretta,

I've been using INR home tester for about two years and, once a while, struggled with the same problem--not being able to get a good blood drop. Just last time of testing, I ruined two test strips before having success. From this time I figured out a technique that hopefully would prevent failure in future tests.

Good blood drop comes from good piercing, which is achieved by making your skin firm and pressing the piercing device firmly against the skin.

Assuming you pierce on the right side of left middle finger. Before piercing, use your left thumb to press the left-front side of the middle finger. Press to the left, as though you gonna snap it, and just hard enough to make the piering area firm, not too hard. Then press the piercing device firmly against the area and pierce it. If you don't see a big blood drop right away, massage the finger tip gently with right thumb.

My failed piercing in the past is attributed to floppy skin and not pressing the device hard enough for fear that it would hurt and make tissue fluid comes out. Doing it like (going for) a snap requires only mild pressures on the skin and leaves no worry about tissue fluid.

Jlant

 

[olefin]

Loretta, Are you using the maximum penetration debt on the Autolet? I know the instructions says start off with the minimum but I started with the maximum to be sure I got plenty blood. Another reason... my trainer told me to.
Also, are you using enough spring force? I also started off with the maximum. I push the Autolet firmly against my finger before pressing the release button. Hardly feel the little prick.
Then wait for a moment for a good hanging blood drop. Massage if needed from palm to fingertip with hand held down.

and leaves no worry about tissue fluid.

JLant, I'm wondering what you mean by tissue fluid?

 

[Ross]

JLant, I'm wondering what you mean by tissue fluid?

The little extra juices you get from squeezing the finger to produce the blood droplet.

 

[olefin]

The little extra juices you get from squeezing the finger to produce the blood droplet.

So, is that a problem?

 

[Cris N]

I've had trouble on a few occasions too. Here are a couple of things that work for me... Stand up and keep your hand and fingers pointed down - the idea being that blood will pool in the extremity. Also, if these really don't seem to work, try sticking your finger twice - close together. And be patient. I usually wipe off the first drop, maybe two or three - after that my finger seems very happy to share a bigger drop.

 

[catwoman]

I had this problem yesterday. Was just being sloppy and hasty in my technique of blood-letting! The drop of blood got sucked up into the little channels but no blood was left in the well. Machine never went to TESTING and never indicated it was an inadequate blood sample.
After the first strip bit the dust, I put another one in, repricked my finger, got a larger sample and that worked.

(This appears to be the same problem encountered March 19 when a lab tech at my doctor's practice seized the day and tried to run an INR on my machine during a comparison test with the clinic's CoaguChek. Luckily I had brought an extra strip with me to my PCP's office.)

 

[Tbone]

You could use the lancets by hand instead of loading them into the lancet popper, or do not load them all the way. I have two kinds of lancets that have been sent to me. The first ones work well, but the other ones are shorter. I put the shorter ones in just enought to hold them.

 

[JLant]

So, is that a problem?

The instruction that comes with my Coaguchek lancing device says "Do not press or squeeze because this will cause the tissue fluid to mix with the blood and can falsify the coagulation values." That's all it said.

 

[catwoman]

The instruction that comes with my Coaguchek lancing device says "Do not press or squeeze because this will cause the tissue fluid to mix with the blood and can falsify the coagulation values." That's all it said.

Sounds more like pressing down on a freshly cooked steak to see how the juices are running.

Here's info at Hemosense's website on how to perform a test:

http://www.hemosense.com/support/faqs.shtml

Click on the e-trainer spot. I'm sure the info would be applicable for a CoaguChek user, too.

 

[olefin]

The instruction that comes with my Coaguchek lancing device says "Do not press or squeeze because this will cause the tissue fluid to mix with the blood and can falsify the coagulation values." That's all it said.

Then it's probably the difference in Coaguchek and Inratio2 instructions.

For there is no mention of concern with tissue fluid in the Inratio2 instructions or lancet device (Autolet) instructions.
"Apply gentle, continuous pressure until a large hanging drop of blood forms. Follow instructions that came with the lancet device".
"Massage the site if necessary, from the palm to the fingertip, with the hand held downwards, until a sufficient blood sample is acquired."

I also had a professional trainer that didn't mention any problem from tissue fluid. She had used the same Coagucheck meter for 6 years in her job at a cardiologist clinic.

 

[Ross]

I squeeze mine like a lemon. The meters really can't test anything but the blood anyhow. I've done every experiment that I can think of to throw mine off and I haven't been successful, including excessive tissue fluid from force.

 

[Eva]

I followed all the advice given above and previosly and the directions, etc! And yet, to my surprise, I wasted three strips today before I got the results which was 3.4!!!

The blood was a lot but was not going into the strip!! I hope next time will be better.

QAS told they were going to send to me some extras, but I did not receive any extra strips and my box was opened by the trainer before. Is it worth contacting QAS and ask them or forget about it (Easier for me)!!

 

[catwoman]

Eva:

Call QAS and see if they will send you some extras.

I've only had 1 problem getting enough of a sample. Maybe it's because my first tester was a ProTime 3, which needs more blood than the INRatio.

Maybe you need to get some Tenderlettes from QAS. The ProTime 3 uses Tenderlettes, rather than the barrel-shaped lancing device that comes with the INRatio. I think the Tenderlette produces a larger blood sample.

Have you taken your INRatio to your doctor's office to show that you can run a test? Perhaps if you did (and insist that only you run the test), you and the RN, doctor or whoever, can analyze your technique and see how to get a decent-size sample best.

 

[Roger Frank]

I have the same machine and occasionally have the same problem. My hands must be warm and I'll squeeze my test finger while triggering the lancing device. This works about 90% of the time (for me) but it's tough to do without assistance.

 

[Eva]

Hi Marsha,

You are right...I shall call QAS and ask for the extras they promised!

I will also take the machine to my cardio and do the test myself there. Last week I took it to my cardio and the nurse did the testing on my machine and theirs and got the same results...he used their strips and I was happy that he saved me mine, which was wasted today.... he did not give me a chance to tell him to watch me how to do it!.

I was thinking of using my hubby's pricker and lancets which he uses for Diabetes checking instead of the Co-agucheck xs' pricker and lancet.