Do you discard the first drop of blood on an accucheck?

Nurses General Nursing

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Specializes in Med-Surg, Ortho, Neuro..

I'm currently in the Peace Corps doing nursing education for my hospital in Mongolia. I'm writing up on how to care for diabetic patients and since they tend not to check blood glucose that often (but they have the means), I'm including a section on how to correctly do an accucheck.

I brought along a couple nursing books that I had when I was in school (I graduated in 2008) to help me with lesson planning, and they say to wipe away the first drop of blood when you do a stick, and test the next drop. I've never actually done this in practice, but I've heard of it and I've seen some people do it in my hospital in America.

There's the reasoning- the first drop could be full of serum (? is this true?), but if you squeeze the finger to get the second drop, the second could be as well. One of the reasons I didn't wipe the first drop was because I tended to have really old diabetic patients who seemed to not have enough blood for one drop, let alone two.

What do you guys think? Is there a best practice for this?

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Specializes in Pediatric/Adolescent, Med-Surg.

I always get rid of the first drop. If the finger was cleaned with alcohol before doing the finger stick the alcohol can cause false results.

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Specializes in ER.

Yes, I always wipe the first drop away with gauze and test the second. I have seen people not do this, and I believe we get similar results, but I was always told this was more accurate.

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I'd follow the manufacturer's instructions.

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Specializes in ER, progressive care.

I always wipe the first drop, because with alcohol it can cause falsely elevated results. This is what I have been taught and it has been a policy in hospitals. I have seen people use the first drop and I don't think it makes much of a difference, if at all, but I just stick with the policies at the hospital.

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Specializes in Med Surg - Renal.
What do you guys think? Is there a best practice for this?

My hospital's policy is to wipe away that first drop. That "first drop" gets mighty small when I have a person who doesn't bleed very well.

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