Kiwiology Posted February 22, 2012 Posted February 22, 2012 Oh don't worry about my balls You might want to see a doctor about that, unless of course you had one of those operations ...
DwayneEMTP Posted February 22, 2012 Posted February 22, 2012 In response to chbare... I think that in the truly physically damaged patient that sorting the fakers from the non's isn't really very important. A couple of exceptions of course being a CVA or head injury. And perhaps my perspective is queered as I've spent very little time with the option of relatively short transport times..But I see two reasons.. The first is that fakers, in my unscientific opinion, are often emotionally damaged. There is much good that we can do for these folks by speaking with them as opposed to spending the entire transport with them listening to us speak about them, or being ignored. I think that fakers are often silently screaming because they've run out of other options to solve their problems. If we do nothing else but make sure that they feel 'seen' and explain what will happen next at the hospital and mention their options for receiving additional help, then I think that we've made a difference. And secondly, there are issues that may be discovered with reported symptoms that are relevant that won't be immediately noticeable by survivable breathing and pulse quality/rate. A well patient now is not necessarily a well patient later. Of course, I'm aware that I'm preaching to the choir, and don't mean to imply that these things would escape your assessment, but only trying to be clear for those that may be reading this thread but not have the history with you to understand the direction that you're attempting to teach, that it's not your feeling that LOC is irrelevant. (Of course, arrogantly assuming that I understand what's going on in the big, fat brain of yours.) Of course, if I'm wrong, and that is your feeling, then above are the reasons that I disagree with you. :-) Dwayne 1
chbare Posted February 22, 2012 Posted February 22, 2012 Absolutely Dwayne. It just felt like we were focusing more on all the neat ways to illicit a response as opposed to the broader picture. Additionally, let's say the hand falls on the head. What does that mean? Is that a definitive sign for us to intubate, push a med, drive faster? What are some of these things we talk about actually telling us? 1
DFIB Posted February 22, 2012 Posted February 22, 2012 In response to chbare... I think that in the truly physically damaged patient that sorting the fakers from the non's isn't really very important. A couple of exceptions of course being a CVA or head injury. And perhaps my perspective is queered as I've spent very little time with the option of relatively short transport times..But I see two reasons.. The first is that fakers, in my unscientific opinion, are often emotionally damaged. There is much good that we can do for these folks by speaking with them as opposed to spending the entire transport with them listening to us speak about them, or being ignored. I think that fakers are often silently screaming because they've run out of other options to solve their problems. If we do nothing else but make sure that they feel 'seen' and explain what will happen next at the hospital and mention their options for receiving additional help, then I think that we've made a difference. And secondly, there are issues that may be discovered with reported symptoms that are relevant that won't be immediately noticeable by survivable breathing and pulse quality/rate. A well patient now is not necessarily a well patient later. Of course, I'm aware that I'm preaching to the choir, and don't mean to imply that these things would escape your assessment, but only trying to be clear for those that may be reading this thread but not have the history with you to understand the direction that you're attempting to teach, that it's not your feeling that LOC is irrelevant. (Of course, arrogantly assuming that I understand what's going on in the big, fat brain of yours.) Of course, if I'm wrong, and that is your feeling, then above are the reasons that I disagree with you. :-) Dwayne Well said. For some reason a similar thought was particularly difficult for me to organize last night. The points that cbare makes in response highlight how unscientific the arm drop practice is. It works more on a scale of averages but what exactly does it mean? Food for thought hmmmm.
DwayneEMTP Posted February 22, 2012 Posted February 22, 2012 As I mentioned before about testing responsiveness being more often about punishing people, as well, the majority of the time that I've seen the arm drop test has been more in the spirit of "Look everyone! See how clever I am?" instead of a search for data. But perhaps my experiences or my perceptions of them are different than others... Dwayne
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