Best lancing device for Coagucheck XS?

[sweep21]

Like most people I get my Warfarin level checked by a nurse every few weeks. Recently I purchased a Coagucheck XS device so that I could take in-between tests just to ensure that my levels were stable. However, I have found the Softclix lancing device supplied with the Coagucheck kit inadequate inasmuch as it consistently fails to puncture my finger deeply enough to obtain enough blood in the short time allowed (i.e. three minutes). As a result I often waste a testing strip. Conversely, my nurse uses a different type of lancing device - a single-use one - which always produces the correct amount of blood in the time allowed and I should like to know the make and grade of that lancing device so that I can use it too. FYI I live in Scotland and no Scottish health board supports self-testing for Warfarin, except Greater Glasgow & Clyde which only supports it for young people under eighteen. Therefore I have to buy all my strips from Roche and anything else required for the Coagucheck XS machine. But I am not too worried about that so long as everything works properly. So, all advice most gratefully received.

[Hidden]

Hi Sweep21, sorry to hear of your problem with the Softclix lance. It sounds like the obvious answer is to ask your nurse what kind of device she uses directly. I have tough skin but have used the softclix device for 15 years without any problem. It helps to have warm hands so that the blood is flowing freely and as it is also obvious that clean hands are good too I usually wash my hands well in warm water first and then give them a brisk rub dry. It all gets the blood flowing. It is of course important for you to turn the ratchet on the nose of the lance all the way up to 5.5 it seems; I assume that you do that. If you do find a better lance do let us all know. All the best.

[sweep21]

Many thanks for your help and advice. I am using the Softclix lancing device at its highest setting, but it is still not doing its job on my fingers. Unfortunately I cannot ask my nurse which lancing device she uses because the anticoagulation service here and my GP are both vehemently opposed to patient self-testing for INR. So I am forced to do it on the QT. After posting this evening I came across a lancing device that looks very similar to the one my nurse uses. It is called HAEMEDIC HAEMOLANCE PLUS and you can read about it by clicking on the links below.

hfs.scot.nhs.uk/publication...

prospectdiagnostics.co.uk/p...

Tomorrow I am going to make further enquiries about this range of lancing devices. I notice that Amazon is selling them too.

amazon.co.uk/Haemolance-Plu...

If this is the same device that my nurse uses it produces the correct amount of blood every time.

[goodnessgracious in reply to sweep21]

Hello, I have been on Wafarin for 17 years now and am also in an area which resistant to self testing. As we take long holidays a couple of times a year and are charged £80 a time if we request testing on board ship - and BOTH of us are on Warfarin!!) you can imagine that we'd love to purchase self testing strips for these occasions. Have looked at the Amazon Haemolance but it only seems to mention Diabetes. Do they give an INR reading do you know? Muriel

[maejane]

Hi I live in the NE of Scotland not far from aberdeen, and i had a battle with my gp regarding self testing they were dead against self testing until I got my consultant involved and I was going abroad for a month and needed to self test, I got my way in the end and the freedom it gives back to you, can you not arrange a meeting with your gp practice and explain that self testing is the safest way (we had to sign a contract and taught by them and have to attend the clinic with our unit and make use they give the same reading) or are there any other patients on warfarin that want to self test, eventually self testing will be rolled out throughout the uk, but I would keep up the request at your gp practice for self testing, it is softclic we use but there are different types.

[Tipper]

I noticed the same difference in lancets too. I've stuck (sorry!) with the Softclix XL lancets though and find that occasionally I don't draw blood. I assume this is because I selected an area with few or no capillaries. I have my clicker set at 5. I also find that one of my fingers fails to give blood, you could try an alternative location?

[daisyd]

Morning

I have had the same problem their are two different lancets

That I have found white ones with a smaller needle Accu-chek

Softclick these I found were not big enough to get a good amount of blood for testing

The best ones are accu-chek softclick xl

The coagucheck company have a help contact number where they are very helpful.

[catsblood]

my little yellew lances work well. practice when not tired etc' don't be panicked by the time factor. am having long battle for prescriptions which I had in Yorkshire but not knowsley so far. my m.p. has helped writing to the srgery, and so has hospital consultative . I m experienced over 20 years but want surgery support. we have a right to prescriptions

[werd]

hi I also live in Scotland,central belt in fact and I have just started self testing,i have been on warfarin for forty years,the softclic lancets seem to work fine at setting 5 with me, I find patience is the key don't pay to much attention to the 15 second coagulation rule

as for your gp being unwilling to supply strips this is just not on go back and demand them,when I decided to go in for self testing I went to my gp and put my case to him at first it was a no goer but by the time I left the consulting room he was on my side and was going to make enquires in the health board,iwent round a few chemists in the area to ask if thy were supplying strips to any one, none were, so I was not to hopful about getting them myself but I did.

you did say your practice nurse uses a different type of lance,if your practice is using a coaguchec pro machine to give an inr reading there and then there by lies the reason he will not supply you with the strips to self test he has just spent many hundreds of pounds on the system and will not be willing to see that revenue stream dry up (ie his warfarin patients) e-mail me at andrewgeddes@blueyonder .co.uk and we will gang up on them

[linkfield]

I use single use safety lancets called Unistik 3 comfort. They come in different sizes and can be bought at the chemist ,but my GP provides a prescription for mine. They are very good for my needs.

[greenrob]

if you remove the plastic guard that protects the needle on thesoftclix,it allows the needle to go deeper

.Not very elegant and you need to be careful,but you will not have any more trouble

[flowerpower21]

Hello sweep21. Welcome to the world of self testing. Does your lancing device not come with an adjustable depth to lance with for ease? I have mine set to the maximum just so that it works first time. But also because I have previously tried the stab it and see method without the lancing pen and didn't like the way I would have to psychology build myself up to do it each time - lol! I hope that you will get the information you need as self testing gives you so much in the way of freedom.

[ianp5uk]

The device supplied in the Coaguchek kit is adjustable for depth. I'm surprised you have a problem. Have you checked you're using it correctly?

[Rich_MV]

Having run many AC clinics in the past, my chosen weapon of choice is the Unistix 3, it's a bit overkill, but often self testers don't press as hard as they should it's human nature. As also stated above nice warm fingers also help. Try to learn the 'pink finger' technique, whereby you squeeze your finger till it turns pink then lance it. Good luck!

[nissanjean in reply to Rich_MV]

Good advice but the manufacturers do not recommend squeezing the finger as this may lead to inaccurate readings/results.

Hope you do not mind my writing this.

Kind regards

[nissanjean]

Hi

Washing your hands in warm water is good advice from a control of infection point of view as well as getting a good flow of blood to the fingers. This is because warmth dilates the blood vessels including capillaries thus increasing blood flow to the area.

Conversely of course cold constricts the blood vessels including capillary blood and restricts blood flow.

So it therefore follows that if the external temperature is cold the blood flow will be restricted and hence difficulty in obtaining an adequate sample of blood.

Use any means to increase the warmth of your body/hand.

I find washing my hands in warm water the quickest method.

Also having a hot drink encourages blood flow .

Just make sure you are warm enough before lancing your finger plus cleaning the finger/hand area to avoid the risk of infection.

Has anyone just tried lancing one's finger without using the device for doing so?

[jeremyfisher]

Just started home INR testing with my mother. Really struggled to get enough blood using the softclix device that came with the machine, and I also felt awful for her as I had to keep lancing her without enough blood coming.

I took my mum to the doctor and they showed me a few key things that made the difference.

(1) Hold her finger tight below the end knuckle to hold the blood in the end of the finger before lancing.

(2) Use the same lancing device as they use - they use the Accu-chek safe-t-proplus. They gave me a few to start and they worked much better than the softclix device that came with the machine, so I've now bought a box myself (amazon.co.uk/Safe-T-Pro-Plu...

(3) Use the lancing device on the longest setting. Better one big prick than lots of little ones that don't work properly!

Home testing now working much better and it saves my mother having to go to the doctor's when she's not feeling well.

We can also take more regular readings, particularly if she misses a dose or gets the dosage wrong - something that's happened a few times in the last few months.

The doctors have been great and fully supported this and we have the strips on prescription.

[1232e0dlm]

Well done !!. However I cannot understand why some surgeries are so obstructive and against self-testing the INR test. They should be glad that we save their nurses the trouble. I have also had a good ECG machine for years and recently found a problem with my heart. The lady Cardiologist was very nice and professional but the nurse that did the ECG at the hospital was a rude, arrogant thing. I nearly left but needed the help which turned out to be not very good in the end. That nurse woman needs to be thankful for the NHS as she would not last the first day in the private sector. Of course the INR strips should be prescribed after all we pay hundreds for the Coaguchek machine.