Faking or not faking? That is the question.

[Dustdevil]

We're not slamming a country, we're slamming your practice of putting alcohol up their noses. You could have any flag next to your picture...I bet most people who read your post didn't even notice you were from a different country. Chill out with that stuff.

Seriously. First, we have no idea where you even are, genius. Second, best I can tell, the US is the only country where monkey medics are the norm in EMS. If you think any of the regulars here believe that there is anything inherently superior, then you haven't read much.

[Eydawn]

If this is a physician approved procedure, NOW I start questioning your educational standards. Before that, I assumed it was a badly learned habit. If the docs are that unintelligent, maybe there IS something amiss.

I don't think anyone is superior. I do, however, think that putting alcohol in someone's nares is assault, as I stated previously. I'll bet I could ask one of our friendly lawyers at Student Legal Services and get a similar answer, too...

But hey, who knows where you are. That's the standard of care I'd expect from a very very developing country in oh, say... really rural South America or Africa. At least you're using alcohol... (SARCASM! SARCASM! NOT A FLAME!)

Just saying, it oughtta be grounds to pause and really think it through if several professional paramedics of all different experience levels have the same reaction to your idea of dealing with fakers...

Wendy

CO EMT-B

[Harold1]

No one ever reacted violently while getting alcohol up their nose. Not in my experience. Hoewever they did wake up.

No one ever filed a complaint either. I think it's typically American to have a lawyer in every corner of the street waiting to take medics to court. You couldn't disagree that a lot of procedures you do aren't needed, but done as a precaution, as prescribed by the book, so that you are covered in case of trouble. Look at the paperwork that you have to do, just so you can't get caught if you're taken to court. When you cross the borders you'll see a big difference in mentality. People get what they need to stay out of trouble, not what what the medic needs to give, so he doesn't get into trouble.

Our little technique may not be the most elegant way of dealing with fakers, but it works just fine. I don't even consider it an important issue. I find it interesting that you guys react predictably and exactly the way an American would react. Like it's soooo out of this world. That's how we know you guys....Americans are the one who would request a plastic surgeon the stitch a simple laceration, they are the ones that expect us to come lights and sirens when they break a leg, they prepare letters to sue the hotels when they fall down a slippery floor, they react hysterical to blood... Do you know how many medical professionals would refuse to ever work in your country just because of the tiredsome way of overreacting to everything?

We don't use alcohol to determine the level of consciousness. It isn't some sort of punishment either. It's an effective stimulus for the patient to wake up.

We're not talking about South America or Africa either. We are in the Dutch Antilles and most of our medics, including me, are trained in the Netherlands and Belgium, were they have excellent EMS systems. I've asked different physicians, nurses and paramedics in both of these countries about this subjection, as I do evaluate my actions seriously. They all said basically the same: it's not nice, but it's harmless. Hey, we all know how Americans can overreact...

[Harold1]

I can assure you that if this was for example a Dutch EMS forum, the reactions would have been very different.

This is not about how medically or ethically responsibly the procedure is. It's about mentality and the way you interpret things.

Yes, in the US I would probably lose my license and face charges. But outside the US borders...people look differently at things.

[letmesleep]

No one ever reacted violently while getting alcohol up their nose. Not in my experience. Hoewever they did wake up.

No one ever filed a complaint either. I think it's typically American to have a lawyer in every corner of the street waiting to take medics to court. You couldn't disagree that a lot of procedures you do aren't needed, but done as a precaution, as prescribed by the book, so that you are covered in case of trouble. Look at the paperwork that you have to do, just so you can't get caught if you're taken to court. When you cross the borders you'll see a big difference in mentality. People get what they need to stay out of trouble, not what what the medic needs to give, so he doesn't get into trouble.

Our little technique may not be the most elegant way of dealing with fakers, but it works just fine. I don't even consider it an important issue. I find it interesting that you guys react predictably and exactly the way an American would react. Like it's soooo out of this world. That's how we know you guys....Americans are the one who would request a plastic surgeon the stitch a simple laceration, they are the ones that expect us to come lights and sirens when they break a leg, they prepare letters to sue the hotels when they fall down a slippery floor, they react hysterical to blood... Do you know how many medical professionals would refuse to ever work in your country just because of the tiredsome way of overreacting to everything?

We don't use alcohol to determine the level of consciousness. It isn't some sort of punishment either. It's an effective stimulus for the patient to wake up.

We're not talking about South America or Africa either. We are in the Dutch Antilles and most of our medics, including me, are trained in the Netherlands and Belgium, were they have excellent EMS systems. I've asked different physicians, nurses and paramedics in both of these countries about this subjection, as I do evaluate my actions seriously. They all said basically the same: it's not nice, but it's harmless. Hey, we all know how Americans can overreact...

Why are you so hell bent on this being an "AMERICAN" thing? I don't care where your from, or where I practice medicine. You little trick is unnecessary, painful, torturous, and has NO place in an ambulance. this is a MEDIC speaking to you as well, it has nothing to do with being AMERICAN.

[Eydawn]

You do have a valid point about our culture being one that over-reacts to some degree, especially where the involvement of lawyers is concerned. That I'll give you. What we are trying to say here is that it IS in fact a question of medical and ethical responsibility, unless you have some sort of *special* isopropyl alcohol solution that says it's ok to use in any fashion internally.

And yes, we are basing that on operating within a US framework. But it rather shocks me that *any* MD, regardless of country, would advocate for this procedure or tolerate it...

Have you ever put alcohol up your nose? Have you ever gotten it accidentally up your nose? Try it. Come back and tell us how it feels. Perhaps unlike many on this forum, as a child I *DID* get isopropyl 70% up my nose by accident, and I can vouch for the fact that it is very painful, dries out the mucous membranes, and results in nosebleeds later in the day.

Yes, we have too many lawyers in America and it colors how we think. I would like to state that most of us, however, attempt to do our best for every patient we see within this system, and most of us prefer the do-no-harm mentality, rather than the "he's drunk, let's give him a 14 gauge so he remembers how much this sucks" or "Let's do a sternal rub because I *know* she's faking" or "Just ignore the fact that he's screaming in pain from an obviously broken leg, he's got a history of drug abuse" type deal.

That make more sense as to *why* we are reacting the way we are? We feel that it is medically inappropriate, lawyers aside...

Hey, maybe you should start a thread about the Dutch EMS system and how you work, since many of us are not aware of it. That could be very enlightening for a lot of us. How does it work over there?

Wendy

CO EMT-B

[Harold1]

As a matter of fact I will give it a try. Not to find out if it is irritating, because that is the exact reason why we use the method.

If EMT City opens a thread about international EMS systems, I will be happy to provide you with all the details about the Netherlands, Belgium and the Netherlands Antilles.

[VentMedic]

After consulting at least a dozen ED-physicians, nurses and paramedics, we would still stick to the practice of shooting 70% alcohol trhough the nose when dealing with fakers.

It is definetely not harmfull.

As a matter of fact I will give it a try. Not to find out if it is irritating, because that is the exact reason why we use the method.

When someone makes statements like the above, it is usually inexperience talking. I also remember this person inquiring if a service hired new paramedics a few threads ago.

[Harold1]

When someone makes statements like the above, it is usually inexperience talking. I also remember this person inquiring if a service hired new paramedics a few threads ago.

When someone makes statements like this, he's usually jumping into gerenalizing conclusions, without really knowing anything.

Sorry to dissapoint you. I started my carreer in EMS in 1998. That's almost 10 years ago.

[Dustdevil]

You do have a valid point about our culture being one that over-reacts to some degree, especially where the involvement of lawyers is concerned. That I'll give you. What we are trying to say here is that it IS in fact a question of medical and ethical responsibility...

Professional integrity is not limited to any one culture. Not a single bit of this discussion has anything to do with where we are. I have Dutch medic/RN friends who I honestly believe to be the best in the world. But that is wholly irrelevant to this discussion. Maybe your (Harold1, not Eydawn) English comprehension isn't so good, although I have never found that to be a problem with any other Dutch medic. But either you are FAILING to understand the context of this discussion, or else you are intentionally trying to change it in order to escape the hole you have dug yourself into. Not a single person here has said anything disparaging about your EMS system as a whole, or made any statement questioning the quality of the medics in your system. Nobody. Not once. We are only questioning two things: the medical and legal validity of this technique you are so fond of, and your personal intelligence.