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Please review these documents and ensure they are urgently cascaded to all relevant staff within your areas, including:

·         Matrons

·         Lead Nurses

·         Ward and department managers

·         Healthcare Assistants supporting POCT testing

·         Pharmacy teams

·         Point of Care Testing (POCT) teams

·         Diabetes services

·         Emergency care teams

·         Critical care teams

·         Maternity services

·         Pediatric services

·         Clinical Governance teams

·         Any other clinicians who use ketone test strips as part of patient care

There is a national shortage of Nova Biomedical StatStrip blood ketone test strips. MFT must use fewer strips so we do not run out. Please follow the steps below now.

ACTION REQUIRED IMMEDIATELY

1. Only use blood ketone test strips when they are needed for urgent care

Use blood ketone tests first for patients who need a quick result for urgent care. This includes:

·                     people who may have, or do have, diabetic ketoacidosis (DKA);

·                     people with type 1 diabetes who are very unwell;

·                     people who may have type 1 diabetes and may also have DKA;

·                     children who need the test;

·                     pregnant people who need the test; and

·                     people who need blood ketone checks while being treated for DKA.

Do not use blood ketone tests for routine checks, or when they are not needed, during the shortage.

2. Use other tests when it is safe to do so

If it is right for the patient, teams should use:

·                     a urine ketone test; and/or

·                     a venous blood gas test to check for too much acid in the blood.

Urine ketone tests are not as accurate as blood ketone tests. Keep the pot tightly closed. Keep the drying pack inside the pot. Damp air can affect the test strip and may give a wrong result.

Urine ketone results can change later than blood ketone results. They may still be positive when DKA is getting better. Use clinical judgement when reading the result.

3. Use fewer strips for quality checks

If your area has more than one StatStrip meter, choose just one meter for ketone tests for now, if this is safe and practical. This will use fewer strips for quality checks.

Until otherwise informed, do ketone quality checks once a week, not every day. Glucose QC remains every 24 hours, and completion of glucose QC allows the meter to continue to be used for patient glucose testing.

4. Make local stock available to move to areas that need it most

MFT is finding all blood ketone strips and moving them to the agreed priority areas. Please help your local Pharmacy and Point of Care Testing teams if they ask about stock in your area.

Do not keep spare strips in your area unless it is a confirmed priority area. Keep strips in their original box. They must have been stored in the right way.

5. Do not use quarantined or recalled batches unless you are told you can

MFT is assessing the risks and benefits of using quarantined stock in an emergency. Until an approved decision is shared, do not use recalled or quarantined batches.

Affected product and lots



Part number	Product name	UDI-DI	Affected lot numbers
46951	TEST STRIP 50CT KET STRIP DUAL PACK	10385480469514	2224295249, 2225013249, 2225072249, 2225079249, 2225111249, 2225118249, 2225167249, 2226068249, 2226070249, 2226110249, 2226173249, 2226117249

Priority clinical areas



Clinical group/site	Priority areas identified
NMGH	ED AMU J6 Critical care  Labour ward
MRI	ED AMU Critical Care Ward 2 (Diabetes Ward).
Wythenshawe / MRI adult cons	Emergency Department AMU Diabetes wards Critical care  Delivery suite
Specialist Hospitals / Children’s	PED PICU PHDU Wards 84 and 85 Delivery units on all three sites.  Starlight at Wythenshawe and Children’s Ward at NMGH Early Pregnancy Assessment Unit
Maternity	Triage and antenatal wards Labour Ward North Manchester Delivery Unit ORC and Delivery Suite Wythenshawe
Trafford	HDU and the Urgent Treatment Centre
LCO	Hospital @ Home

More information

Read the NHS England guide on which patients should have blood ketone tests during the shortage.

We will share more updates when we know how many strips are available and when more will arrive.

Thank you for acting now. This will save strips for the patients who need them most.