27th October 2020, Dr Chee L Khoo
Some of you would have read about the use of the multi-use lancet devices for testing different individuals that was in mandatory quarantine in Victoria between March and August this year. The lancets were disposable but the device holding the lancets were not. I thought everyone knew. I was wrong. Judging by the comments online after the publication of that issue in the Medical Republic, I suspect many of you don’t actually know the infection risk these devices pose and I felt the imperative to write this urgent article. If you or your nurse have attended the annual Diabetes Injectable Masterclass, you would have been briefed on this important infection risk.
The availability of a glucometer is part of our practice accreditation standards and pretty much all practices would have got a free glucometer from one of the pharmaceutical device manufacturers for use in the practice. All glucometers come with a multi-use lancet device (see Figure 1). The lancets are discarded after each use and a new lancet is inserted. However, the device is re-used. It is acceptable for the same patient to reuse his or her own multi-use device (although they sometimes use it on a relative!) but not, if they are used on different patients in the practice.
Because of infection risk from remnants of blood or other bodily fluids on parts of the device, we are NOT ALLOWED use a multi-use lancet device in the practice. This is despite changing a new lancet for each test. We are not talking about Covid-19 risks. We are talking about blood borne infections the likes of HIV, Hepatitis B and Hepatitis C. The risk may not be high but is an unacceptable greater-than-zero risk. If this occurred at your practice, you will be advised to talk to your indemnity insurer as soon as possible.
Although we don’t test blood glucose on patients at the practice that frequently, we must be equipped to conduct a safe blood glucose test if the situation arises. Your practice must only use single-use lancet device (see Figure 2). These can be ordered and purchased from your usual medical suppliers or local chemist. Please ensure that your practice staff is also aware of this directive.
The Victorian Health Department have now issued a health advisory last week and is now contact tracing. There will be some anxious travellers out there.