Eyelash Reflex

[fireflymedic]

Fl Medic - great resource and explanation !

[zzyzx]

Fiznat,

Kern County, CA, still uses ammonia inhalants.

[tom5706]

a few drops of water on the eyelid also will do it, as the raise their hand to wipe it away.

[FL_Medic]

We only took the ammonia inhalants off last year. Tell me, what harm is there in treating a patient that is faking an unconscious state like they are truly unconscious?

[wrmedic82]

The "Hand Drop Over Face" technique I've heard of, not so the alcohol up the nose. Besides, as I'm BLS, per protocols, I don't have access to a syringe.

New York State DoH outlawed "Ammonia Inhalants", sometimes called "Snappers", over 30 years ago. Does anyone have them still included in local protocols? Please give the area/country, if you do, just for my own interest and curiosity.

We carry them on our trucks, and work great with hispanicus Panicus.

Ft Worth, Tx

[FL_Medic]

I hope that's just a joke. Please explain if not...

[HERBIE1]

I hope that's just a joke. Please explain if not...

Many variations on that phrase- "Aye" tach(as in aye, aye, aye...), is another. I know of a few more, far more unPC that I will omit.

It's just a crude way to describe someone, most often a female of Hispanic origin, who becomes so upset they can no longer be reasoned with and discussion with them is no longer possible.

I've seen similar reactions in people of Arab descent too.

Similar to this is the idea of "running amok", which is actually a recognized psychiatric issue common in the Malaysian culture:

( As an EMTB student nearly 30 years ago, doing clinical time, I first heard this explanation from an ER doctor when we were confronted with a hysterical Malaysian patient)

<h1 id="firstHeading" class="firstHeading">Running amok</h1> <h3 id=siteSub">From Wikipedia, the free encyclopedia</h3> Jump to: navigation, search This article is about the amok behaviour and state of mind. For other potential meanings, see Amok (disambiguation). Running amok, sometimes referred to as simply amok (also spelled amuck or amuk), is derived from the Malay/Indonesian/Filipino word amuk, meaning "mad with rage" (uncontrollable rage).

The word was in use in India during the British Empire, originally to describe an elephant gone mad, separated from its herd, running wild and causing devastation. The word was made popular by the colonial tales of Rudyard Kipling.

Although commonly used in a colloquial and less-violent sense, the phrase is particularly associated with a specific sociopathic culture-bound syndrome in Malaysian culture. In a typical case of running amok, a male who has shown no previous sign of anger or any inclination to violence will acquire a weapon and, in a sudden frenzy, will attempt to kill or seriously injure anyone he encounters. Amok episodes of this kind normally end with the attacker being killed by bystanders, or committing suicide.

The syndrome of "Amok" is found in the DSM-IV TR: "[1]"

[HERBIE1]

As to the "tricks" to determine responsiveness-I've seen hard core regulars who could pass any of those noxious stimuli tests- the arm drop, no reaction to ammonia inhalants, sternal rubs- the works.

At that point, treat them as if they are really unresponsive and let the hospital sort it out. Gawd only knows why people play these games, but it takes far more effort to "prove" they are faking it then to simply play their game and bring them in. Same with getting a refusal of service- people waste so much time and energy justifying/documenting why someone was not transported- it's far easier to transport them. No amount of rationalization, reasoning, or badgering will change their minds or their behaviors.

Abusers will be abusers.

[FL_Medic]

My point is that if someone appears unresponsive, treat them as such. Ammonia inhalants are useless!! Unless you want a way to adequately display your ignorance. You will not harm your patient if you treat the symptoms they present with. You are no cooler for determining that someone is "faking". AVPU does not include ammonia inhalants or racial slurs. Be professional, don't just do what you've seen the old timers do. If the paramedic position is ever to be respected, we have to raise the bar on ourselves.

[HERBIE1]

My point is that if someone appears unresponsive, treat them as such. Ammonia inhalants are useless!! Unless you want a way to adequately display your ignorance. You will not harm your patient if you treat the symptoms they present with. You are no cooler for determining that someone is "faking". AVPU does not include ammonia inhalants or racial slurs. Be professional, don't just do what you've seen the old timers do. If the paramedic position is ever to be respected, we have to raise the bar on ourselves.

Judging by your listed age, you are relatively new to the business. It seems that right or wrong, many people go through phases in their careers. You start out eager, full of energy and ready to save the world. Depending on your mentors, you will eventually learn to either be a good provider or a bad one. You may go through a disillusioned phase when you learn about the realities of prehospital care- the abusers, how many times we are little more than taxi cabs, the pay, the lack of respect, etc. You may develop bad habits, you may become burned out- it's usually a difficult time. At some point, most come to terms with the what the job is all about- helping as many as you can- and that can mean anything from holding a little old lady's hand, making a balloon from a rubber glove for a sick kid, or dumping the drug box into someone who is doing their best to die on you.

You realize that it's silly to make the job more stressful than it already is and that. You also realize the "old timers" have paved the way for the next generation and while you might not agree with everything they did, you understand how things have changed over the years- for good and bad. Pick up the good things from folks, and resolve not to repeat their mistakes.

You also eventually realize that this is a profession that is the hardest job you'll ever love.