Acetaminophen interference with Nova StatStrip^® Glucose Meter: case report with bench top confirmation.

Area of Science:

• Clinical Chemistry
• Toxicology
• Point-of-Care Testing

Background:

• Point-of-care glucose meters are crucial for assessing patients with altered mental status.
• Interference from common substances like acetaminophen is a known concern for glucose meters.
• The Nova StatStrip® glucose meter has been previously recognized for its resistance to interference.

Observation:

• A case report details a patient with a very high acetaminophen concentration (465 mg/L) presenting after an overdose.
• Attempts to measure glucose using the Nova StatStrip® glucose meter resulted in error messages across five devices.
• Laboratory analysis confirmed the high acetaminophen level and a glucose reading of 180 mg/dL.

Findings:

• Acetaminophen concentrations of 399 mg/L and above were found to interfere with the Nova StatStrip® glucose meter in laboratory spiking studies.
• This interference, particularly at very high acetaminophen levels, has not been previously documented for this specific device.
• The study highlights a potential limitation in the reliability of point-of-care glucose monitoring in severe acetaminophen toxicity.

Implications:

• Clinicians must be aware of potential Nova StatStrip® glucose meter interference in cases of significant acetaminophen overdose.
• Relying solely on point-of-care glucose readings in such scenarios could lead to misdiagnosis or delayed treatment.
• Confirmation of glucose levels via laboratory analysis may be necessary for patients with suspected or confirmed high acetaminophen concentrations.