What gauge lancet do I need?

[Fran]

Hi everyone. I'm new to this, so bear with me, please. I don't have a valve replacement, but I do have a pacemaker and am in constant a-fib. So I'm on Warfarin. I just ordered the INRatio meter, but I'm a bit scared. I know all of you have been through a lot more, but I'm a wuss! I've used 28 gauge lancets for diabetes testing, but I've been told that I need to use 21 gauge for PT/INR testing to keep the blood from "hemalyzing", which I think means that if I try to get the blood through a smaller puncture, the blood cells will break and the reading will be wrong.

Well, a 28 is uncomfortable enough, but manageable. A 21 would hurt like #$#%$%. Is anyone using a 28 or 30 for PT/INR testing? Is it accurate? What about this whole "hemolyzing" issue?

HELP!!!

Fran

 

[catwoman]

Fran:

Unlike diabetic testing, we don't test 3Xday. Many of us test only once a week. Therefore, whatever discomfort or momentary pain we feel is of such duration and of such infrequency during a week's time that we can tolerate it.

And it sure beats lab draws!!!!!!!!!!!!!

 

[Ross]

I use 28ga with no problems. I think the hemolyzing thing is a smoke screen. It never made a lick of difference in readings with me. I used the 21ga for about 50 tests and decided I didn't need a huge hole for a tiny drop of blood.

 

[geebee]

I think it really depends on how you bleed. I use a 28ga for testing glucose and a 21ga for the INRatio. I do not bleed enough to get enough blood for the INRatio with a 28ga.

I do not find the 21ga all that painful tho. I can certainly feel it more than the 28ga but only intially for such a brief microsecond. It does not continue to hurt.

You should try using a 28ga, see how large a drop of blood you can get without "milking" your finger too much. If you can get a large drop (about the size of a small pea), you should be fine using the 28.

I do not know about hemolyzing thing. I don't think blood cells break that easily or if it is even an issue. But, maybe someone else will know.

Have fun with your INRatio - it is a great little monitor.

 

[jeffp]

I use a 27g and its not too much of a sting. Tried 30g for a bit but never got enough of a drop of blood (I guess I've got thick skin). I do have as backup in by INRatio kit some lancets that have a rounded blade knife edge to them, they leave quite an ouch, but boy does that thing get it bleeding. I had used it a few times with the 30g to get more blood as there is a limited time to get the sample to the strip.

 

[Marty]

Tenderlett

Tenderlett

Hi everyone. I'm new to this, so bear with me, please. I don't have a valve replacement, but I do have a pacemaker and am in constant a-fib. So I'm on Warfarin. I just ordered the INRatio meter, but I'm a bit scared. I know all of you have been through a lot more, but I'm a wuss! I've used 28 gauge lancets for diabetes testing, but I've been told that I need to use 21 gauge for PT/INR testing to keep the blood from "hemalyzing", which I think means that if I try to get the blood through a smaller puncture, the blood cells will break and the reading will be wrong.

Well, a 28 is uncomfortable enough, but manageable. A 21 would hurt like #$#%$%. Is anyone using a 28 or 30 for PT/INR testing? Is it accurate? What about this whole "hemolyzing" issue?

HELP!!!

Fran

I recommend Tenderlett. It does a "slice" 1.75 mm deep. Hardly feel it and bleeds good. Try itcmed.com or QAS.

 

[fyrfytr]

Hey Fran,
I am with Marty, try the Tenderlett. I have tried a lot of the lancets and Lance from QAS let me try the Tenderlett at the reunion last year and I think it is the best.
Take Care

 

[Fran]

Thank you!

Thank you!

Well, I received my INRatio a few days ago. I tried it and got a really wierd result that I knew was wrong. But I didn't aim real well and sorta smushed it around a bit. I tried again today (using a 28 gauge) and got a 2.7! I also went to the lab today, so when I get the results, I'll see how they compare.

I used a 15 microliter cap tube and it filled to the line, but that didn't seem to be enough --- any idea why?

Fran

 

[Ross]

If you used the microsafe tube and got all the blood in the well, it shouldn't have been a problem. I've had quite a few tubes now that drew the blood in and wouldn't release. At that point, I result to a new stick and just hope I hit the well with the drop of blood off of my finger. Be sure all that alcohol is dry before you puncture too.

 

[Fran]

Thanks, Ross. The tube DID release all the blood, and I THOUGHT I got it all in the well, but maybe I missed with some --- I don't know. Practice makes perfect.

When you do a second stick, do you use a new strip also? Even if the original stick is still bleeding and you can get it on the strip immediately?

 

[Ross]

If any blood went into the well on the first stick, then yes, I open a new strip, but if it simply didn't release and the well is empty, I hurry to get a new stick and get the drop of blood in there.

 

[RCB]

What?

What?

I don't understand, 4-10 ga. is the smallest I've ever use and there always
has been plenty of blood.....................................................

 

[Fran]

Thanks, Ross. I guess I'll get the hang of it after a while.

 

[Fran]

RCB --- forgive my stupidity, but what do you mean by 4-10 ga? I'm used to numbers like 28 ga. or 21 ga.

I think I can get enough blood, but I'm used to glucose testing, and I think I'm misjudging when I have enough. Also, if I get too much, it starts running. That's why I'm using the microsafe cap tube. But somehow that wasn't enough. Maybe I missed the well a bit.

 

[geebee]

Fran,

QAS has two types of 15ul capillary tubes. One is the Micro-Safe that has Hemosense's name on it. The other is a generic. The first batch of tubes I bought were the generic and they worked perfectly. The second batch was the Micro-Safe tubes and I could not get them to work. I kept getting error messages and wasting strips. I finally ordered the generic again and have not had any problems.

Hemosense seems to think I am crazy and imagining this problem. However, someone else on this site (can't think of who right now) had the same issue. Now you seem to be having the problem also. See if QVC will send you a few of the other tubes and see if those work for you.

Supposedly both tubes are 15ul in size but something is amiss with the Micro-Safe tubes. That's my story and I am sticking to it.

 

[Ross]

I don't understand, 4-10 ga. is the smallest I've ever use and there always
has been plenty of blood.....................................................

.410 works, but if your going to get stupid, get real stupid and use a 10 gauge. Yeah, I know, overkill.

 

[RCB]

Sorry Fran

Sorry Fran

RCB --- forgive my stupidity, but what do you mean by 4-10 ga? I'm used to numbers like 28 ga. or 21 ga.

I think I can get enough blood, but I'm used to glucose testing, and I think I'm misjudging when I have enough. Also, if I get too much, it starts running. That's why I'm using the microsafe cap tube. But somehow that wasn't enough. Maybe I missed the well a bit.

When I post at night, I get a tipsy and make stupid jokes. 4-10 is a
small shotgun gauge.

 

[Fran]

Duh!

Duh!

Well, DUH! Of course I know what a 10 gauge shotgun is!
The mind just wasn't working in that direction!

Thanks for your help, everyone!

 

[ClickerTicker]

I've been using 28G (0.4mm) ever since I received my CoaguChek. Didn't even realise there were varying gauges of lancet - just used what was available via our doctors. Never had much of a problem drawing enough blood, but I gather other monitors may need more. I wouldn't want to make a bigger hole... the bleeding can occasionally take a while to stop, even with 28G. In UK, the standard finger-clicker seems to be the "Accu-Chek Softclix" with lancets of the same brand, don't know how that matches up with US models.