Seizures real vs fake - page 2

Ok so there was a patient/IM that had a seizure (perhaps, unsure) and the staff that went were stating that it was fake because she was alert and oriented. I was wondering, how do you handle the... Read More

  1. Visit  JDougRN profile page
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    WHOOP- I LOVE these- Being an ED nurse, we sure see a lot of them- We use the amonia ampule as well- Another good trick I learned from a Neurologist- If someone is having a "Seizure" or a "Coma"- taking a needle cover and putting it up inside their nose and wiggeling it will always casue them to react. Easy to tell the fakers from the real thing- much more accurate than the "Hand drop on the face"- Too many frequent fliers know that is coming-
  2. Visit  Pranqster profile page
    3
    A trick that was passed on to me was "Protecting their airway" with a nasal airway (NPA). That generally seems to weed out the fakers!
  3. Visit  Orca profile page
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    One of my favored methods for sorting out the real from the fake was an ammonia inhalant.
    This is our method of choice. It really separates the fakers.
    katkonk likes this.
  4. Visit  Neats profile page
    2
    We respond in a fashion that is evidenced based to include lab theraputic values, then if this behavior continues well it becomes a safety issue for our patients and they must wear a helmut while awake so they do not hurt themselves. Females will almost always have noseizures after the topic of helmuts come up. Men it takes one or two episodes before they get it.
    Again we respond always like it is real, you never know.
    IrishErin and kimmyjonc like this.
  5. Visit  Findingmynitch profile page
    2
    I have become a real fan of the ammonia inhalants. However, I am a bit intrigued by using an NPA to "protect the airway". Could that be considered battery?!? Inquiring minds wanna know!!
    katkonk and Orca like this.
  6. Visit  OrganizedChaos profile page
    3
    I loved using ammonia inhalants! Then when I started working at a chemical treatment facility for adolescents there was one client who they claimed to have "seizures". They kept sending her out to the ER, repeatedly! I was tired of this & pulled on my corrections knowledge, grabbed some ammonia inhalants, cracked them & put them to her nose. It cracked me up to see her try to hold her breath then turn red, sit up & "come out of it".
    katkonk, Orca, and Findingmynitch like this.
  7. Visit  Orca profile page
    3
    Quote from Two Sheds
    I laughed at y'all's comments about the smelling salts because I have started to use those and they truly are "miracle workers" lol.
    They have helped us to separate a lot of the pretenders.

    What's crazy is that we have a couple of inmates who are so predictable that the COs will call us in medical saying, "I/M ____ is going to have a seizure in 5 minutes...just a heads-up." Sure, enough, it happens. And they are such BAD actors! They come out of the "seizure" and they'll be like, "Wh- wh- where am I?" Nauseating, but funny as heck!
    I was doing pill call on the yard one night. For some reason, we started about 45 minutes later than usual. While out on rounds, I got a call from an officer on a unit we hadn't visited yet, saying that an inmate in his unit was asking where his medications were. This particular inmate was notorious for fake seizures. I told the officer that we were running about 45 minutes late, but that we would be there. Not five minutes later, there was a man down call from this unit. We suspended pill call and went to the unit to find this inmate flopping on the floor of his cell like a beached halibut. I looked at him. "Knock it off." He stopped, sat up and looked at me. "Aren't you going to give me my meds?", he asked. "No, and I will be writing a notice of charges for abuse of the man down system. And by the way, you have delayed pill call for yourself and everyone else on this yard by another 45 minutes."

    This is how we outed this one malingerer: the Dr. came to the unit when the emergency was called, and he observed as we stated things like, "I don't know...if it was a real seizure, his jaw would be jutting out more," and the I/M jutted his jaw out. Then we said, "Yeah, his right leg would be at more of an angle" and other ridiculous, fake "symptoms." Every symptom we mentioned, the I/M would start doing. The Dr. finally ordered that next time he has a "seizure," he is to be put into the turtle suit (the green suicide getup) and put into the observation room for 4 hours. That room is FREEZING so it took only 1 time in there for him to be "cured."
    This is brilliant. I love the creativity that went into this.

    One thing I used to do, especially on night shift, is give malingerers what I call "concrete therapy". The two large holding cells at the front of our clinic have concrete benches - hard, uncomfortable and very cold in the winter. If a malingerer came to the clinic (seizures and chest pains, two of the most popular symptoms to fake, were the usual reasons they were there), I would leave him in the holding cell for 3-4 hours after the clinic visit for observation. When the inmate asked when he was going back to his cell, I would tell him that I had to observe him long enough to make sure that he was OK to return to the yard. Punishment? Yes, but easily medically justifiable. That cured a lot of our late night visitors.
    Last edit by Orca on Sep 17, '13
    TriciaJ, katkonk, and Findingmynitch like this.
  8. Visit  Findingmynitch profile page
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  9. Visit  Findingmynitch profile page
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  10. Visit  Findingmynitch profile page
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    Quote from itzvalerie
    I loved using ammonia inhalants! Then when I started working at a chemical treatment facility for adolescents there was one client who they claimed to have "seizures". They kept sending her out to the ER, repeatedly! I was tired of this & pulled on my corrections knowledge, grabbed some ammonia inhalants, cracked them & put them to her nose. It cracked me up to see her try to hold her breath then turn red, sit up & "come out of it".

    More recently, I have been working in a psych facility and have to agree that ammonia inhalants come in mighty handy there.
    OrganizedChaos likes this.
  11. Visit  claudja profile page
    1
    I am an RN who lost her job and had to get disability when I started having "seizures" at 37. After finding me unconscious while lying in the hallway for the second time in my hospital work setting, I am not allowed to work, drive, bathe alone, swim alone, or ride a bike, according to multiple neurologists. I don't have epilepsy, I apparently have psychogenic non-epileptic seizures. What you might think is fake is very real to me, as I have no control over when it stops or starts and it has taken over my life. I am sure you have people who put these things on to get attention but keep in mind that there actually might be something going on that needs treatment.
    Studentnurse365 likes this.
  12. Visit  psysn profile page
    1
    claudja, I'm so sorry you're having to go through that. We had an inmate with psychogenic seizures as a result of conversion disorder, and it's difficult for even professionals to understand that what is often referred to as "psuedoseizures" in the medical literature does not mean "fake," but actually means "looks like." I hope you are able to find some sort of help for whatever is causing your psychogenic seizures. There is a huge difference between what you are experiencing and what happens when an inmate fakes a seizure event. I hope my comment did not offend you, as it was not my intent to make light of conditions such as yours.
    TriciaJ likes this.
  13. Visit  Sam J. profile page
    0
    Quote from psysn
    One trick a coworker shared is rubbing a handful of ice on the person's belly. If they're faking they recover instantly...
    And if they are NOT faking it? Are you kidding me? Is that 'trick' in your procedure manual?

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