Ammonia Inhalants, A.K.A. "Smelling Salts"

[ERDoc]

Just out of curiosity, why is anyone putting the ammonia into anyone's nose? They're called an inhalant for a reason.

With experience, you start to tell the BS from the legit. I have no problems using them to speed up a pt's workup, but usually the threat of a foley is more effective (especially in men).

[HERBIE1]

Just out of curiosity, why is anyone putting the ammonia into anyone's nose? They're called an inhalant for a reason.

With experience, you start to tell the BS from the legit. I have no problems using them to speed up a pt's workup, but usually the threat of a foley is more effective (especially in men).

It would work on me.

The threat of large bore IV's works well too.

Then again, I've also seen people who seem to be completely immune to inhalants.

[Richard B the EMT]

... usually the threat of a foley is more effective (especially in men).

Any guy who has ever had a Foley inserted would not only stop faking, but run away, on such threat.

[P_Instructor]

Used the ammonia in the past, have done the hand drop, etc..... experience and exposure to the 'fakers' only makes you more aware in certain instances. Why do more harm. Look at the patient. Corneal pain, why. Just simply check without them noticing (of course their eyes are closed), lightly touch the eyelash. 99.99999% of your 'fakers' will have a eyelid flinch. Usually (percentage data unknown), the fakers will have a positive reflex, where the real patients will not. Just a tidbit. Does no harm also.

[kohlerrf]

Ammonia inhalants can be a noxious stimuli and they can make my otherwise calm psycho or drunk very upset,combative and could escalate the situation . Why do I need this? Let them play possum on the way to the hospital who cares. Keep the situation calm and treat the pt symptomatically and arrive at the hospital uninjured.

[DCP Whit]

Not sure about using it on someone else (not a working EMT, YET) but had it used on myself. Passed out in a mosh pit. I got dragged out of the venue by two large punks. Don't remember the first dose, the second dose felt like being pulled out of a hole. Kind of like in Train Spotting when he is pulled out of his OD. Paramedic said he hasn't ever had to use two....

In short, didn't have to go to the ER, didn't have to pay for the ambulance ride, the venue owner gave me a free 3 dollar bottle of water, and I got to see the rest of the show. The medic said he hadn't seen anyone he had to use two to wake up lol. In my case, easy treatment.

If only I could have that and a fresh brew of coffee in the morning, I wouldn't ever be late to work. Ha

[Richard B the EMT]

As I commented earlier on, in this string, if the body is unconscious, it is that way for a reason, as a part of the self healing process. The fact that it took you 2 "snappers" to awaken you, and the crew didn't insist you go and be seen at an ER, personally, I find more than a bit disturbing. Something was happening to you, and they didn't really do anything to help you.

Admittedly not knowing all the facts on this call where you were the patient, I think the crew might have just gotten lucky, and missed letting you die. "Duty to act" and all, and they really did not, but I wasn't on that call. Again, I don't have all the information about this particular call.

Edited October 23, 2010 by Richard B the EMT

[crotchitymedic1986]

To me this is like blaming guns for gun-deaths. Ammonia Inhalants are innocent, it is medical personnel with the wrong attitude that are dangerous. As clearly stated by everyone, I believe it is important to know that the patient is a faker, but that does not mean that I embarass them, or get my jollies by punishing them in one way or another. I just do not want to waste valuable supplies and resources for someone who is having an emotional problem. I am not saying we shouldn't treat, but when you call in an "unresponsive" patient, the hospital is going to dedicate alot of unecessary resources (on-call Neuro, clear the CT scanner, tie up the "big trauma/code room". SO I am not a proponent for not trying to figure it out, but I do not thing you should do things that are obviously for your amusement, such as:

Cupping the ammonia inhalants in several 4x4s so the ammonia is more concentrated and cant leak out.

Putting alcohol preps in a syringe and squirting liquid alcohol in their nostrils.

Starting multiple large bore IVs, or missing IVs on purpose.

I am not even a fan of the "arm/hand drop" test, as you can cause an injury if the patient is not faking.

Anyone who does the things listed above, or similar, should lose their certification.

[Richard B the EMT]

I have an "open to all to whom it applies" type question: For those who use the arm/hand drop test, do you do it from no more than 6 inches above the face? I figure that it is too low a height to cause any damage, but I never recalled hearing of any specified height while in training.

[Just Plain Ruff]

As I commented earlier on, in this string, if the body is unconscious, it is that way for a reason, as a part of the self healing process. The fact that it took you 2 "snappers" to awaken you, and the crew didn't insist you go and be seen at an ER, personally, I find more than a bit disturbing. Something was happening to you, and they didn't really do anything to help you.

Admittedly not knowing all the facts on this call where you were the patient, I think the crew might have just gotten lucky, and missed letting you die. "Duty to act" and all, and they really did not, but I wasn't on that call. Again, I don't have all the information about this particular call.

Richard, this was at a mosh pit. I think that completely answers the question of why they didn't transport the person involved.

If a patient doesn't respond to the first ammonia inhalant, I'm not about to say "Dum de dum dum, maybe if one isn't good enough, the two'll do the trick"

If you don't respond to the first inhalant then you are too out of it to not go to the ER so your butt is on my gurney and on the way to the hospital.