Faking or not faking? That is the question.

[Canadian Caesar]

This "non-American" EMS professional says NO to alcohol in the nose.

The fact is: not only are there many professionals here telling you that the practice might be unacceptable, many of them thought your suggestion was so ridiculous that initially it was regarded as a joke. Got that? Not an unusual approach, not a questionable procedure, A JOKE! If that doesn't ring any alarm bells in your head I don't know what should.

"Do not use internally" means "do not use internally" whether in Dutch or English doesn't matter.

Perhaps after centuries of exposure, the Dutch people have developed some sort of tolerance for nasal exposure to alcohol that makes it acceptable. :roll:

I strongly feel that there are far more effective and less "potentially" harmful ways to ascertain true unconsciousness, some of which have already been discussed here. It seems to be that your procedure would be right at home in your idea of overreacting to a situation. Talk about using a sledgehammer on a thumbtack... Alcohol in the nose?!?!

I guess the trait of overreacting is not so distinctly an American trait as you so brilliantly hypothesized.

[AnthonyM83]

Yup, you definitely keep going back to the "American thing". So, what if it is...from our perspective we're just trying to justify causing pain. Legalities is a good backup, but even before considering legalities I'm considering if I really want to flush someone's nose with alcohol because it feels horrible and I can't justify doing that to a patient, personally (and neither can medical journals).

[mobey]

Here is another non-american's perspective.

Alcohol up the nose is the most unprofessional treatment still used in EMS in my opinion.

I had a elderly lady last week who was clearly faking it, maintaining upper body posture, failed the "flutter" test, winced from IV stick, etc,etc.

Did I jam some chemical up her nose??? HECK NO!

I treated her like any unCx patient (including attempting OPA, and considered then dismissed NPA). I discovered her level of conciousness, treated her appropriatly, and let the hospital take care of the rest! What is wrong with that?

Ya if this is the same person every time, it must be dealt with accordingly, but really, if they sit through sternal rubs and IV sticks, let them fake all they want.

I don't NEED a patient to open thier eyes and tell me thier faking, I assess better than that!

God this jamming crap up the nose reminds me of a bunch of short insecure bald guys comparing who has the most painful way to assess LOC!!

*Ya man just jam your thumb behind thier ear*,

*No Way man, drop thier hand on thier face*,

*Hey man I just jam alcohol up thier nose... works every time hahaha *

Yup just screams health care professional..... :roll:

[defib_wizard]

Why would you worry about a person faking if you treat what your assessment shows?

This is very simple, you can give painful stimulis to determine a response. Some of the stimulis is a treatment; i,e-

The patient takes an opa or doesn't gag when suctioned; it's intubation time!

If you want to give noxious stimuli in a pts nose put an npa in. If they accept it your helping support their airway.

I've never seen 2 cc of alcohol IN . But I have seen laryngospasm from ammonia ampules. :shock:

You perform an assessment, administer treatment, Then reassess and document the response.

Rule number 1 of all forms of medicine- First do no harm!

plus if you determine they are faking unresponsiveness your pt won't be annoy you on the way to the hospital.