Context: Point-of-care glucose meters are an integral part in the assessment of patients with altered mental status. For this reason, glucose meters are checked for interference from commonly encountered substances, including acetaminophen. The Nova StatStrip® glucose meter has previously been reported to be resistant to interference. We report a case of a very high acetaminophen concentration causing interference with this point-of-care glucose meter.Case report: A 25-year-old female presented after an overdose of acetaminophen and diphenhydramine combination product. Patient was minimally responsive, so a point-of-care glucose check was attempted using the Nova StatStrip® glucose meter. Five different meters were attempted, and each showed an error message. Laboratory analysis using Beckman Coulter® Unicel DxC 800 revealed a glucose of 180 mg/dL and an acetaminophen concentration of 465 mg/L. Serum spiked with acetaminophen at different concentrations revealed interference with the Nova StatStrip® glucose meter at a concentration of 399 mg/L and above. To our knowledge, this interference with the Nova StatStrip® glucose meter has not been reported in the medical literature.Conclusion: Very high levels of acetaminophen can interfere with point-of-care glucose meters, even those that have previously been reported to be robust such as the Nova StatStrip® glucose meter. Clinicians should be aware of this possible interference when treating patients with acetaminophen overdose.

译文

背景: 护理点血糖仪是评估精神状态改变的患者不可或缺的一部分。因此,检查血糖仪是否受到常见物质 (包括对乙酰氨基酚) 的干扰。新星StatStrip®以前有报道称血糖仪具有抗干扰性。我们报告了一个非常高的对乙酰氨基酚浓度引起干扰的病例。病例报告: 一名25岁的女性在过量服用对乙酰氨基酚和苯海拉明的组合产品后出现。患者反应最小,因此尝试使用Nova StatStrip进行护理点血糖检查®血糖仪。尝试了五个不同的仪表,每个仪表都显示一条错误消息。贝克曼库尔特实验室分析®Unicel DxC 800显示180  mg/dL的葡萄糖和465  mg/L的对乙酰氨基酚浓度。添加不同浓度的对乙酰氨基酚的血清显示出对新星StatStrip的干扰®浓度为399  mg/L及以上的血糖仪。据我们所知,这种对新星StatStrip的干扰®在医学文献中没有报道血糖仪。结论: 非常高水平的对乙酰氨基酚可以干扰护理点血糖仪,甚至以前报道过的那些健壮的如Nova StatStrip®血糖仪。治疗对乙酰氨基酚过量患者时,临床医生应注意这种可能的干扰。

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