Faking or not faking? That is the question.

[Arizonaffcep]

Ya...the 70% ETOH can cause real damage...Some of the ED docs I work with will occasionally (seen it once in 2 yrs) will squirt a little (very little) NS in the back of the throat, to trigger a gag (this is VERY LITTLE NS).

I do have a funny story about faking...had I not seen it with my own eyes, I wouldn't have believed it.

Ok...I was working FT at a FD, and my wife (gf at the time, who is also a medic) is out volunteering with us. We get a call (the unit was dual medic) for difficulty breathing. U/A, we found the PT, a 30's yof, supine in the throws (per her fiance) of a BAD asthma attack...Ok...so we get her loaded on the cot and start to drive to...the most distant hospital in town (of course). My wife was attending, I was driving. About 1/2 way there...I here the PT say "I think I'm gonna have a seizure." So I ask my wife if she wants me to pull over and give her a hand...She says no, and I here her tell the PT (who is now doing the "fish out of water" routine), that if she doesn't stop, she'll have to sing to her. Yes, you did read that correctly . So...PT continues to seize, and so my wife puts one hand on her hip and holds the railing on the ceiling, and starts singing "I'm a little tea pot!" No kidding, the PT started to laugh so hard (yes, still doing the "fish out of water"), that she couldn't "fake it" anymore and laid still for the rest of the trip.

[iMac]

I didn't read the whole post but regardless of what the patient was doing you treat them the same. It is frustrating when you know or have a good idea that they are likely faking but at the end of the day you never know and you don't want to make a mistake because you assumed they were faking.

Had a guy come in this morning who has been here 7 times in the last week and I knew the second he came in it was a fake but we still cared and treated him as tho it was legit.

Even those who cry wolf can from time to time actually have a real complaint.

Cheers

[firedoc5]

I've had a few partners that were real joke tellers. If we knew someone was faking, we'd start telling jokes and they would wind up cracking up. You'd see them just barely cracking a smile and doing their best not to laugh.

[pguy280]

Faking or not treat them the same do no harm. I have an ability that certainly confuses many of my pt. I am a puppeteer and I an can alter and throw my voice. when I come across a faker i usually yell in my man voice to my partner were losing him or her. I wait for my partners reply. Then in a soft womans voice I say the patients name and suggest they follow me to the light. This opens eyes fast. I have also used the tube suggestion to and have actually torn open bandage packages for the sound effect.

[firedoc5]

Faking or not treat them the same do no harm. I have an ability that certainly confuses many of my pt. I am a puppeteer and I an can alter and throw my voice. when I come across a faker i usually yell in my man voice to my partner were losing him or her. I wait for my partners reply. Then in a soft womans voice I say the patients name and suggest they follow me to the light. This opens eyes fast. I have also used the tube suggestion to and have actually torn open bandage packages for the sound effect.

Wish I was that talented. Throwing one's voice, that can open up a whole new world.

[CBEMT]

I'll freely admit to not being the world's greatest fake-catcher. :-k

[WendyT]

I agree with what has been said.

2. NEVER NEVER NEVER do that stupid ass arm test!!! Instructors that still teach that are idiots. You do not do it for the exact reason mentioned above. It is stupid and can create more problems than you think. A simple, light flicker of the eyelashes works for most people cause they are unexpecting it, or pinch the earlobe, nipple. There are so many other less harmful ways to test someone.

:roll:

[AnthonyM83]

I like the idea of using comedy to spot the fakers...there's much you can do there. Wish I was naturally funnier, though. I'll have to remember specific jokes. Though, jokes might not work with some individual who are "hard from the streets" like transients who aren't even listening to us who just want a warm bed.

[letmesleep]

AnthonyM83, your exactly right about the transients looking for a warm bed, and possibly a good meal. I remember when I worked in St Louis we had a guy who would call all the time. Instead of us getting mad, upset, bent out of shape, yada yada (that was for Dwayne) we would simply pull up in front of the address, tap the horn, he would come outside and get in the truck. En route we would knock out some VS, and give him about 15 mins of chat time on the way to Barnes. Turn around time on theses calls were typically about 40 to 45 mins, which we considered a break from the craziness. He was faking all the way to get out of the weather (no matter what it was like outside), and get a meal out of the hospital. Waste of time and resources? Absolutely, but we would get him a safe place for a couple of hours and us a break............

[AnthonyM83]

LetMeSleep, I just straight up ask them if they just need a place to sleep. If they say yes, I'm cool with them and write that as my chief complaint. No problem. When they fake is when I lose my bedside manner.