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Then you treat appropriately, right? What is the down side if you're wrong? I see increading numbers of people thinking that they're cool for 'catchin' those that are faking, but what's the upside if you're right? What's the downside if you're wrong? The upside is minor, bragging rights at best, the downside is a bruise to your paramedic soul, so do you find that to be a worthwhile cost/benefit? If so, then I think that you're shameful. Care for patients, care for people, but let the wankers brag about withholding care. Just my thoughts.. Dwayne

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http://www.ems1.com/ems-advocacy/articles/885722-EMS-approved-as-an-emergency-medicine-subspecialty/

In many areas, for years "poppers" were almost a first line drug. Not saying it's right, but that's the way it used to be. Now, as was noted, "proving" someone is faking is a waste of time and is basically irrelevant. If they are going through all the trouble of feigning unresponsiveness, let the hospital deal with the drama. Whatever the reason for their act, it's nothing we will be able to "fix" in the brief period they are with us. Psychological issues, domestic problems- nothing we will be able to cure in a few minutes. Besides, in my book- quiet, compliant, and passive is far better than angry and combative. I found that over time, many people even developed a tolerance to these things- they simply had no effect on them. Now some of the justifications I heard for using them are so that we do not "overtreat" someone who has no serious medical issues, but if we check a blood glucose, maybe push Narcan, then what else will we do for someone who has stable vitals? Yes, there is a cost factor, but really, we cannot be concerned about that either. If a person has a simple syncopal episode- from fear, emotional distress, pain, etc, then they will quickly wake up on their own anyway. Treat the underlying problem and transport.

Sure, people get into the field to help others but being able to help yourself is also important. It's unfortunate that my American counterparts get paid the little that they do. As much as I'd love to live and work in a nice warm climate somewhere south of me, I can't picture that much of a decrease in pay. We are also starting to get saturated with green providers trying to break into the field. There are some changes being made here right now that a 'precious few' feel will benefit everyone. Unfortunately that's not the case, so several are jumping ship and leaving the province before EMS crashes here like it did in another Canadian province not too long ago. As for people (in any walk of life) who live beyond their means, it can only be done for so long before it catches up with them. I only know a few in EMS who did so, they're all facing bankrupcy and most are friends who never made much to begin with ...

I've never had occasion to use them. There are other methods we can utilize if we suspect that the patient is faking unconciousness, like scraping the bottom of the feet, brushing the eyelashes and the 'hand drop' tests. I've heard stories from other crews about how they picked up a drunk during their shift and popped 3 or 4 of them into the NRB, and then laughed about how fast the patient 'came to'... Yeah, we've got to do things that will cause discomfort and even pain, but to intentionally do it is abuse. I've heard crew members talking about how they intentionally used the largest bore cath they had on a drunk, unlicensed pharmacist or the 'urban outdoorsman' just because they could. I find these practices appalling, and I'm utterly disgusted by those that feel the need to employ such tactics for their amusement!

The hand drop isn't very likely to hurt them, and even the ammonia inhalants have, at least according to the British Journal of Sports Medicine, never caused harm to any patients. Though I must ask, what "non-archaic" methods do you use to assess responsiveness? Is it just the painful response and corneal reflex or do you do something else to differentiate between the truly obtunded and those who are playing possum?

IF THATS WHAT YOUR DOING @ THE TIME,THEN THAT DOES MAKE YOU AN AMBULANCE DRIVER.IN SOME STATES YOU DON'T HAVE TO BE EMS, JUST HAVE YOUR EVOC & CPR TO BE ON A TRUCK.ANYONE THAT DOESN'T LIKE DRIVING SHOULDN'T BE IN EMS .IF YOUR NOT HIGHER UP THE SO CALLED FOOD CHAIN ,YOU WILL BE STUCK DRIVING FOR SOMEONE WHO IS :? .I PERSONALLY BECAME AN EMT TO ACCUALLY DO THE JOB, NOT BE A DESIGNATED DRIVER FOR ALS.DON'T GET ME WRONG, I HIGHLY APPRECIATE ALL ABOVE ME IN TRAINING. I JUST GET TIRED OF BEING A 'TAXI DRIVER' SOMETIMES.

WHAT! Things have changed. You didn't used to have to pay to chat and now you do. I have lost my job and have no financial income coming in and this is when it's the crucial time that I need someone to chat with and you have to pay to chat. NUTS. I can pay a phychologist if I had the money. This is probably why I have not come back because I new that there would be a cost. You know God never decides to charge us for talking to him. Just think about that. If you are charging for people to talk, then you have lost your faith that God will meet all your needs(bills) in His time. I would like to stay here and chat was my most important thing, but if it's gonna cost me anything I don't think I will be coming back. I'll miss yall. Dina Krasny