Faking high FSBS?

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Had an inmate today that repeatedly had a "high" FSBS. He was given 10 units reg. and still read "high" after a couple of hours. Received 6 more units and drank a bunch of water. Continued to read between 515 and "high." Was getting ready to send him to the infirmary for closer monitoring and he becames panicked and nervously said, "Okay, okay. Let me just check it one more time." MIRACULOUSLY, it was down to 102. Was using 3 different glucometers at this point and each read between 99 and 102. All of this occured between 1600 and 2330. What are ways that one can manipulate a FSBS? One of the nurses said they can put sugar on their fingers. Was hoping for more details such as dry sugar or rubbing wet sugar solution on hands and letting it dry? Not too sure. I THOUGHT I was watching him do the FSBS, but apparantly not that well. Of course, quickly became concerned that inmate's sugar would be too low since the insulin given was based on apparant false readings. Any thoughts or experiences?

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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.

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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 :)

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Specializes in ED.

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?

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Specializes in Wound Care, LTC, Sub-Acute, Vents.

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

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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.

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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.

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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 :)

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Specializes in ortho, hospice volunteer, psych,.

my husband has been diabetic since he was in elementary school. we had used the crest "regular" toothpaste for years and years, then we switched to the crest cinnamon flavor. tastes fabulous, but for some unknown reason his bs results began to spike for no good reason. after much detective work, we discovered that even a teeny tiny bit of toothpaste residue on his finger or hand could influence results. we still use the cinnamon toothpaste but he washes his hands, does the bs, then brushes his teeth. that was all it took. weird... could be have discovered some off-beat thing causes a similar rise?

kathy

shar pei mom:paw::paw:

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Wow, great info - Who knew????

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Specializes in Psych, corrections.

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

mary

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Specializes in Flight, ER, Transport, ICU/Critical Care.

This is a first (happens rarely, at this point :p) 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! :eek: )

Good Luck. You jail nurses rock!

:angel:

Practice SAFE!

;)

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