What is the first step prior to a glucose heelstick for a newborn?

Warming the newborn's heel is crucial as the first step prior to performing a glucose heelstick. This is because warming helps to increase blood flow to the area, making it easier to obtain a blood sample. When the heel is warm, the capillary beds are more dilated, which can facilitate a more successful and less traumatic puncture, yielding a better quality sample and minimizing the risk of complications.

Cleaning the puncture site with alcohol does not provide the same benefits as warming. In fact, while it is important to clean the site to reduce the risk of infection, this should be done after warming the heel, not before. Cleaning should be performed with a gentle antiseptic or alcohol swab, but the primary focus initially should be on ensuring adequate blood flow through warming.

Using a specialized glucose meter and covering the heel with a bandage are important procedural steps, but they occur after the sample has been successfully obtained. Therefore, the essential first step is to ensure adequate blood circulation to the heel by warming it, which lays the groundwork for a safe and effective heelstick procedure.