Fingersticks

Flo., BSN, RN · Oct 6, 2011

Nope. On some people that drop is all you are going to get.

mmm cdiff · Oct 6, 2011

Yes, it's said that isopropyl alcohol has the potential to cause a falsely high reading.

Then again, I'm looking at the article about this and they were published in the '80s. I found this on the accu-check website: "In contrast to former recommendations, it is not necessary to discard the first drop of blood and use only the second one for glucose monitoring. There is no significant difference in blood glucose values measured with the first and the second drop."

Double-Helix, BSN, RN · Oct 6, 2011

Our policy is to wipe away the first drop because it supposedly contains fluid from the tissue in the fingertip and will dilute the sample.

turnforthenurse, MSN, NP · Oct 6, 2011

Wipe the first drop with gauze then take the second sample. Alcohol can cause a falsely elevated reading.

CVmursenary · Oct 6, 2011

interesting, i dont wipe with alcohol or use the 2nd drop

Murse901, MSN, RN · Oct 6, 2011

It is not a policy at my facility, but I do it, and it's a good practice to get into.

This is just anecdotal evidence, but prior to my getting into the habit of wiping away the first drop, I have had a few extremely abnormal readings on an accucheck if I didn't wipe away the alcohol, followed by rechecking the blood from the same site and getting a more reasonable result after wiping.

I was always taught to wipe away the first drop. Got into a lazy habit of not doing it a few times, got those crazy results, and now I always wipe.

SuesquatchRN, BSN, RN · Oct 6, 2011

I was told to use gauze to wipe away the first drop and was then told that the NYS DOH will ding you on infection control if you do that. I took to waiting a sec for the alcohol to evaporate. I have gotten the false highs when I didn't wait.

Florencebyondthepale · Oct 6, 2011

You wipe away the first drop because it has a high amount of serous fluid and can cause an inaccurate reading. You should allow the alcohol to air dry because that can also cause an inaccurate reading. You should not wipe away the alcohol because that can contaminate the area and cause an infection. The maker of the glucometer, however, can provide the best information in terms of getting an accurate sample.

grandee3 · Oct 6, 2011

I agree with Flo, sometimes a drop is all you gonna get.

Murse901, MSN, RN · Oct 7, 2011

You should not wipe away the alcohol because that can contaminate the area and cause an infection.

I'm all about infection control. I wash my hands every chance I get and I'm probably bankrupting the hospital with the number of times I use the hand sanitizer stations (just kidding). :jester:

But seriously? Wiping a finger with a clean 4x4 is going to set the site up for infection from a fingerstick? Sometimes I think we get a little tunnel-visioned and overzealous when it comes to infection control.

Perhaps we should be putting a little dab of antibiotic ointment on that fingerstick site before we cover the booboo with a sterile 2x2 and tegaderm.

Forever Sunshine, ASN, RN · Oct 7, 2011

If the hands are visibly soiled aka they have food on their hands. I don't use an alcohol wipe prior to fingerstick. It does mess with the reading. And some of their poor oversticked fingers have no blood left.