Faking high FSBS?

Although I have not personally worked with inmates, I would not put anything past any of them. Manipulation is one of their everyday tools for living.

They are good manipulators :) I've just never seen anyone manipulate a FSBS and want to be better prepared next time. I KNOW he somehow manipulated the numbers--you don't go from over 500 to 100 in 2 or 3 minutes, but I don't know HOW he did it. This is going to drive me crazy :)

I think it is just using food or sugar rubbed on the fingers. at our hospital we are taught to scrub fingers really well because of the false high readings. I would guess that he probably did something like that, although it is disconcerting that he had so much insulin and water and that his sugar didn't drop more if he was faking...I would think it would drop pretty low. maybe initially it was up that high and then he used sugar or food on his fingers to create a falsely elevated level?

yes fingers that touched food tend to give high fsbs readings, at least in my experience where i work (ltc).

every time i get "hi", i would redo it on another hand and clean it really well and i would get the acceptable number.

try smearing your finger with orange juice and let it dry and do fsbs. you will get "hi" as a result.

angel

i am very particular to blood sugar and repeat it when it reads HI because you dont want them to give insulin and later on found them unconscious or passed out.

In the facilities I worked at the nurse did the BG readings rather than self by the inmate. Might be a good policy to do the reading yourself after a very high reading done by an inmate.

Thanks everyone for your replies. We do let them stick their own finger, but it did get to the point where I was taking his finger and placing the blood on the strip. We were also using 3 machines at one time to make sure we were getting acccuracte readings. I don't ususally work this facility, but the regular nurse said this guy is always manipulating everything and will stockpile BP pills and then take them at the same time. Very untrustworthy. He must have been wiping something on his hands. I suspect he was high to begin with and then started playing the game later in the evening. We have over 50 inmates doing FSBS and insulins and his was the only unusual situation. I would just love to see what was in his pocket :)

Wow, great info - Who knew????

...a good handwash with a bit of soap, and lotsa rinse water has gotten very good results for me.

mary

This is a first (happens rarely, at this point ) for me - never heard of this as an issue. Looking back - I may have had a puzzling result or two.

When I am just lost and nearing the treat point, I would confirm with a venous specimen. As a matter of protocol - I'd think that a blood draw for lab confirmation useful and you can always "steal" a drop and repeat the FSBS with a venous specimen. Alternately, you can just draw up a venous sample using a small syringe/small needle (1ml/25 gauge) and use a small amount to do another BS at point of care. There were studies done that show accurate correlation between a capillary and venous sample (as they should! )

Good Luck. You jail nurses rock!

:angel:

Practice SAFE!

He must have been wiping something on his hands. I suspect he was high to begin with and then started playing the game later in the evening. We have over 50 inmates doing FSBS and insulins and his was the only unusual situation. I would just love to see what was in his pocket.

For a result that was that bizarre....I would have told him of my suspicion in a calm and professional manner and asked the officer to "shake him down". Then THEY could find whatever was in his pocket! And if something was found, then he would get "a case" or "a ticket" or whatever your institution calls it. Also, agree with the EMT-I would have seen what a venous draw showed, and/or if I had any I-STAT machine (or something similar) may have run a cartridge on that to verify.

I have to say that I have learned a lot from this post. I really did not think it was possible to manipulate a FSBS this way. Obviously, we have seen people who really aren't fasting and read high, but never knew that it was possible to apply something to the hands to affect that. GREAT post!