20cc syringe and an ammonia inhalant

[spenac]

AK I'm with you. Let them stay quite. Makes the ride more pleasant. When sure they are faking I tell the patient I know you are faking and then I buckle up and enjoy the ride.

[Chief1C]

Suppose the liquid and bits of glass shot out the tip, into their nose... or eye.. What does that prove? We don't even carry Ammonia Inhalants. If someone has fainted out of emotional response, etc; or is faking it; we still treat them as a syncope victim. If you're treatment is splashing some water on them and shoving a cloth soaked with spirits of ammonia or a crush ampule in their face... Wake up, it's not 1950.

[VentMedic]

I didn't think Ammonia inhalants were around anymore either. Even health care providers themselves including RNs, RRTs, and EMT(P)s can become bronchospastic around ammonia. I also see several people in the ED each month just from ammonia based cleaning products. Our hospital environmental services dept has to be real careful about the products they buy due to the large number of respiratory patients.

You may or may not get the desired effect from the patient, but someone near you could be seriously compromised including bystanders.

In the ED, I prefer pulling a ventilator up along side the bed and discussing intubation, paralytics, trach, "life support" etc. Usually when the wrist restaints go on for "tube and line" precautions and we start to get the head in intubating position there are some signs of consciousness.

In the ambulance, I just monitor their vitals and airway for documentation and enjoy the quiet also.

[Just Plain Ruff]

ok let me ask this question. You can answer it honestly and say you did it or you can say you saw this happen somewhere or whatever.

What techniques or noxious stimuli have you used to wake a faker?

I have performed the pencil/pen on the nail bed

sternal rub

Arm drop

and blunt objects being pressed on the heel of the foot

I've heard of needles being poked on the feet and fingers

D-stick for the hell of it

eye gouging (finger in the space between the eye and the top of the orbit)

pectoral pinch

ammonia

and others that I cannot think of right now.

What have others here seen or done?

[spenac]

Ruff d-stick must be done to rule out diabetic cause. Hand drop often. Sternal rub to establish if alert to painful stimuli. I have run dull side of shears on bottom of feet to see if any reaction.

I knew a female paramedic that would do a Texas titty twister to test for faking male and female patients.

[Just Plain Ruff]

spenac, I know the d-stick thing. I may have misunderstood you but I'm talking about doing additional d-sticks just for the heck of it to get them to wake up from faking.

[VentMedic]

spenac, I know the d-stick thing. I may have misunderstood you but I'm talking about doing additional d-sticks just for the heck of it to get them to wake up from faking.

But, you don't want to leave too many marks on them.

I have used a couple of tongue depressors on the center under side of the upper and lower lips where the "web" is felt. This is how I occasionally get an intern's finger or ETT freed from someone's mouth which is quick and less messy than unhinging the jaw. It hurts like heck but usually doesn't leave a visible mark.

[CBEMT]

I usually use the pen on the thumb, and pinching the earlobes.

[ccmedoc]

an increase in resp distress as well as ammonia burns by the ammonia getting on the facial skin.

Most likely vomiting, resp. distress, and we have had patients with blisters on their face from the transporting unit putting them in NRB or under the line of a nasal cannula bilaterally...not pretty :shock:

I like this one..

I knew a female paramedic that would do a Texas titty twister to test for faking male and female patients.

..That rocks.. :headbang:

[firedoc5]

Had a gal faking after a MVA. I think she was trying to get out of a DUI. The medic I was with just lifted up the bottom of her shirt and went "Wheww". He didn't actually look up it, just lifted the shirt. But she got a big ole grin on her face. It was priceless.