title: Using the first drop of blood for monitoring blood glucose values in critically ill patients: An observational study.
abstract: BACKGROUND
  Using the first drop or second drop of blood while measuring blood glucose (BG) values.
  
  
  OBJECTIVE
  The study was planned to compare the BG values from the first and second drops of blood.
  The study was conducted at the Main Intensive Care Unit, PGIMER, Chandigarh, India.
  
  
  METHODS
  This study was a comparative study.
  
  
  METHODS
  Ninety patients aged 2-93 years were enrolled in this study. BG values from the first and second drops of blood were taken and compared.
  
  
  METHODS
  Agreement between two drops was assessed using Bland-Altman analysis. A bias of <10 mg/dl was considered clinically acceptable. Linear regression of the mean difference (bias) with the BG readings was performed.
  
  
  RESULTS
  One thousand four hundred and seven pairs of BG readings were taken from the enrolled patients. BG values had a bias of 3.9 ± 14.9 mg/dl. Nearly 96.7% of BG readings were within the limits of agreement. The absolute difference between first and second drops of blood was calculated; nearly 75.4% of the readings had fallen between 0 and 10 mg/dl, i.e. clinically acceptable range.
  
  
  CONCLUSIONS
  There is no compete concordance of values of blood glucose between the first and the second drops of blood; any of the drops can be used for measuring BG values as the difference is not statistically significant. However, if hands are visibly clean and to decrease the blood loss in the critically ill patients where the BG values are measured frequently, using the first drop of blood is advised.
authors.affiliation: Department of Nursing, Government Medical College and Hospital, Sector - 32, Chandigarh, India.
authors.forename: Sunita
authors.initials: S
authors.lastname: Saini
authors.affiliation: National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sukhpal
authors.initials: S
authors.lastname: Kaur
authors.affiliation: National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Karobi
authors.initials: K
authors.lastname: Das
authors.affiliation: Department of Anaesthesia and Critical Care Unit, PGIMER, Chandigarh, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Saini
keywords: Blood glucose monitoring; critically ill patients; first and second drops of blood