Welcome to surgery. I see rounds. My name is Jeff Guy. I want to talk today a little bit about the methods in which we measure blood glucose at the bedside. And let's go back a little bit in years that when I was a surgical resident, you can always tell a good surgical resident because they typically had a Guayek card and the developer in their pocket so that when they did their rectal exam in the

emergency room or on the general history and physical of their patients, they had the guillac

card immediately available and would be able to tell that the patient's stool was either

guillac positive or guiac negative. However, with the development of quality improvements and

point of care testing, we were deemed unsuitable

to be able to carry a Guayat card. You could do surgery and take out somebody's appendix

and maybe repair their rupture to Dominole Arctic aneurysm, but we didn't have the ability

to sit there and wipe stool on a Guayat card and add a couple drops of developer to determine

whether the color of the paper was purple or not.

That had to be into the realm of point of care testing and required a quality improvement program.

And more and more of those types of programs came along such that even a pH paper,

even though that you might have a bachelor's degree in chemistry or organic chemistry,

that in a clinical situation that

of a patient needed to have a pH test because they were covered with acid or base, that you

wonder how to go, you had to undergo an in-service to assess whether you can actually read

a piece of litmus paper. And hence is the world that we live in regards to the point of care

testing. Not to sound overly bitter, because I'm really not.

I think a lot of that is important to assure that the results that we're getting from our

assessments at the bedside and so forth are appropriate.

It was part of our standard routine as a medical student to do graham stains on patients, particularly in the medical service,

every floor had a microscope and we would do graham stains and have a culture or a bacterial

gram stain almost immediately when looking at urine or sputum or what have you.

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