Serum Ketone Fingerstick Test
Serum Ketone Fingerstick Testing in Pediatrics
Point-of-care ketone testing is essential for monitoring ketosis in various pediatric conditions, particularly diabetic ketoacidosis (DKA) and metabolic disorders.
Key Points
- Measures β-hydroxybutyrate (BOHB)
- More accurate than urine ketones
- Rapid results (30 seconds)
- Minimal blood volume required (1.5 µL)
- Essential for DKA monitoring
Indications
- Suspected DKA
- High blood glucose (>250 mg/dL)
- Acute illness in diabetic patients
- Nausea/vomiting in diabetes
- Metabolic disorder monitoring
- Ketogenic diet management
Testing Methodology
Measurement Principles
- Electrochemical Detection:
- Enzyme-based reaction
- Measures β-hydroxybutyrate specifically
- Digital quantitative result
- Equipment Requirements:
- Ketone meter
- Test strips
- Quality control solutions
- Calibration materials
Pre-analytical Considerations
- Strip Storage:
- Temperature requirements
- Humidity control
- Expiration date monitoring
- Quality Control:
- Daily QC checks
- Temperature monitoring
- Operator competency
Step-by-Step Procedure
Required Materials
- Ketone meter
- Test strips
- Lancet device
- Alcohol swabs
- Gauze/cotton balls
- Gloves
- Sharps container
Procedure Steps
- Preparation:
- Verify patient identity
- Assemble materials
- Check strip expiration
- Don gloves
- Sample Collection:
- Select appropriate site
- Clean with alcohol
- Allow to dry completely
- Lance site
- Wipe away first drop
- Testing:
- Insert strip into meter
- Apply blood drop
- Wait for result (30 seconds)
- Record result
- Post-Procedure:
- Apply pressure to site
- Dispose of materials
- Document results
- Remove gloves
Result Interpretation
Normal Values
- Non-diabetic: <0.6 mmol/L
- Well-controlled diabetes: <0.6 mmol/L
- Poor control: 0.6-1.5 mmol/L
- Impending DKA: 1.6-3.0 mmol/L
- DKA: >3.0 mmol/L
Clinical Correlation
- DKA Assessment:
- Mild: 3.0-3.9 mmol/L
- Moderate: 4.0-7.0 mmol/L
- Severe: >7.0 mmol/L
- Treatment Monitoring:
- Target reduction rate
- Resolution criteria
- Frequency of monitoring
Clinical Applications and Special Considerations
DKA Management
- Initial Assessment:
- Diagnostic criteria
- Severity classification
- Treatment initiation
- Monitoring:
- Frequency guidelines
- Treatment response
- Resolution criteria
Special Populations
- Ketogenic Diet:
- Target ranges
- Monitoring frequency
- Diet adjustments
- Metabolic Disorders:
- Specific protocols
- Emergency management
- Long-term monitoring
Troubleshooting
- Common Errors:
- Insufficient sample
- Strip issues
- Meter malfunctions
- Quality Assurance:
- Calibration checks
- Control testing
- Documentation requirements
