7. Performing PT INR Test

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Make sure that you have all the supplies needed before you start, including, a 21 gauge lancet, Sample Transfer Tubes, sterile alcohol prep pads, gauze square, and a biohazard, or sharps, waste container.

For fingerstick blood testing, increasing the flow of blood in the finger will help you capture a good drop of blood.
Before you lance the finger, have the patient warm their hand by washing it in warm water, or by using a hand warmer. Ensure that the patient’s hand is dry before testing.
Do not use fingers with tight rings, scars, calluses, or other features that prevent getting good access to the blood.
One of the middle or index fingers on either hand is recommended.
Gently squeeze or massage the finger to be lanced towards the tip of the finger.
Clean the fingertip with an alcohol wipe using one side for the first cleaning. Use the second side for a final wipe. Dry the fingertip with gauze to remove any excess. Place the patient’s hand on a solid surface with the palm of the hand facing up.
Remove the cap from the single use 21-gauge lancet.
Place the lancet against the skin. Holding the body of the lancet, push down firmly against the finger to lance the surface of the skin.

Collect the sample using a Sample Transfer Tube. Hold the transfer tube below the bulb and horizontal or with the bulb pointing slight towards the ground to let gravity assist the filling of the tube. Touch the tip of the tube to the bead of blood until the blood reaches the black line and stops moving. Do not squeeze the bulb of the transfer tube at any point during the collection process.

Shift your thumb and index finger to the flat sides of the bulb on the transfer tube covering the air holes. Rest your hand on the meter. Roll your hand towards the test strip and touch the tip of the transfer tube down onto the bottom of the sample application well where the green light is flashing.

Apply gentle pressure to the bulb until the blood just exits the tube. Do not produce air bubbles. Hold that pressure on the bulb while you pull your hand away from the meter to avoid back-suctioning the sample. You must apply the blood to the test strip within 15 seconds of lancing the finger. Once the sample transfer tube is filled apply the sample immediately to the test strip.

The light should go out and the meter should display “Testing Please Wait”. The testing time is the patient’s actual clotting time as the system produces a true prothrombin time.
Never add more blood to the test strip. Never collect a second sample from the same fingerstick.

When testing is complete, the meter beeps once and the results (INR and Prothrombin Time appear on the screen. If an error is displayed, either not enough blood sample was applied or the sample had air bubbles in it. Refer to the trouble shooting section of the manual. Remove the strip and retest with a new strip and fresh fingerstick from a different finger.

Remove the test strip and properly dispose along with the sample transfer tube and lancet. Turn off the meter. Record and report the result which can also be recalled from the memory.

Turn the meter off by pressing the POWER button when you are finished testing. If left unattended, the meter automatically turns off in a few minutes.

The last 100 test results are stored in memory with the time and date.

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