Normal SQBS, critically low venous BS?

[TigerGalLE, BSN, RN]

Has anyone ever seen this happen? I work in ICU. Patient had acute mental status change on floor, SQBS 130s, went to radiology for stat CT of head. Went into respiratory arrest in CT. Code called. Intubated. SQBS checked 120s. Brought to ICU, SQBS check again 130. CT of head was negative but patient was posturing with positive babinski. No spontaneous respirations. We anticipated severe CVA.

BMP drawn. SQBS on BMP 26. SQBS rechecked 118. Stat glucose drawn to ensure first lab drawn wasn't diluted. Glucose 31. D50 given and patient woke up and was extubated within 10 minutes.

Patient was not edematous, good pulses. We were all dumbfounded. I've seen low finger stick BS with normal venous BS but not the other way around....

Any ideas? Her sugar was checked twice on the floor (with 2 different machines). Once during code (different machine). And twice in ICU. All normal.

Tiger

[WSU_Ally_RN, BSN, RN]

maybe the pt's fingers weren't cleaned well and they had some sugary substance on them??

[JenniferSews]

I have had the same results in our SNF. The pt needed to be sent out, and numerous bs readings from separate machines were over 100. The patient was able to remember the RN relaying their bs and that they were getting 2 U of insulin. The ER said it was a med error and that we'd given way more insulin. BS readings at the ER were in the 30s.

[Redhead28]

Perhaps sugar so low that they had shunted blood to central, and what was still available in periphreal was 100's? I've never seen this before.

[blondy2061h, MSN, RN]

I've seen SQBS abbreviation here many times. I know it means glucose, but what does it stand for?

[GilaRRT]

Subcutaneous Blood Sugar I assume, never heard that one.

[TigerGalLE, BSN, RN]

Semi-quantitative blood sugar

[blondy2061h, MSN, RN]

Semi-quantitative blood sugar

Thanks. So what does that mean? Just a capillary one done on a meter?

I never really trusted our glucose meters. Is the patient on dialysis at all? I know some of the chemicals used in dialysis can effect capillary glucose results. There's also a few other things, but can't recall specifically. I think it depends on the enzyme the strip uses to analyze. I think I recall hearing a low HCT or hypernatremia can also effect some strips. Hopefully someone can provide insight. I might look into it more when I'm feeling less brain dead.

[traveler85]

Is there any way the finger was still wet from the alcohol wipe? I've seen that make a difference in glucose readings

[wildlaurel]

Sometimes "milking" the patients finger - squeezing really hard, can elevate the blood glucose reading. I'm not sure it would do it by that much though.

[GilaRRT]

Semiquantatitive would be something like a test strip then? Even the point of care glucometers will give you a numerical reading, technically quantitative. I was a "bit" off on my guess it appears.

[TigerGalLE, BSN, RN]

The patient was a peritoneal dialysis patient. But she did not run the night before.