Painful Stimuli Limits?

[pacman]

I came across this article. What are your limits in assessing with painful stimuli?

http://www.nj.com/news/index.ssf/2007/08/f...ted_for_pu.html

Frenchtown man indicted for punching rescue worker

by Ralph R. Ortega

Wednesday August 22, 2007, 2:43 PM

A Frenchtown man who allegedly punched a volunteer rescuer in the face after she allegedly slappped him in an effort to revive him has been indicted on aggravated assault charges.

An indictment handed up in Hunterdon County on Tuesday and released today charges Warren Wiseburn, 58, with one count of second-degree aggravated assault, a crime punishable by up to 10 years in jail.

The charges stem from an April 21 encounter between Wiseburn and Patty Moran Atheras, captain of Frenchtown's Emergency Medical Service squad. After the incident, police charged Wiseburn with assault, and he in turn has filed a citizen's complaint of simple assault against Atheras.

Atheras - who claimed she sustained a concussion, lost the hearing in her right ear and suffered damaged vision in her right eye as a result of the incident - said the indictment provided her some level of comfort.

"In a small way I feel vindicated," said Atheras, who said her EMT license was revoked after the confrontation, which began when authorities and rescue workers were summoned to a retirement house where Wiseburn lives after he was found "unresponsive," according to police.

Atheras, who was among the volunteer EMS responders, "started to try to get some kind of response from (Wiseburn) during which time she was smacking (Wiseburn) in the face," Frenchtown Police Chief Al Kurylka said at the time.

Wiseburn then came to, according to the chief, "and punched her in the face."

Yay for my 50th post! lol

[itku2er]

Brings up some interesting thoughts what are the limits for painful stimuli ?

[Just Plain Ruff]

the limits are as far as you can get without getting smacked in return or a lawsuit

just don't go overboard on the painful stimuli.

[Kaisu]

Slapping someone to assess level of consciousness is incorrect. I think I would have punched her too....

[CKMedic]

I believe anything that will leave a mark is the limit. There are many ways to get a PAINFUL RESPONSE. We are not taught to slap. I live by securing the airway a true test to responsiveness. if you get hit then. you were doing what you were taught, no case..in my county GCS 8 or below gets intubated.

[mrmeaner]

How many would testify in court that slapping a patients face is an acceptable method of assessing mental status? She should have lost her license as she has. The only methods I have ever been taught were: sternal rub, pinching the palm of the hand, and direct pressure on a nail bed.

[Redcell19512]

If by "slap" she drew her hand back and let loose with a decent amount of force such that you could hear the skin on skin contact across the room...well then that's a bit much. If the slap was more of a tap, like you might tap someone on the shoulder to get their attention, that's different. I generally stay away from the face. Pull on an arm hair or do a finger stick for the blood sugar check (if they're unconcsious I'd be doing it anyway).

Sounds like he let her have it pretty good, concussion, hearing loss, vision damage...ouch.

[Michael]

How many would testify in court that slapping a patients face is an acceptable method of assessing mental status?

Seems like an acceptable method of assessing the mental status of... [spoil:1096d5f724]...the caregiver.[/spoil:1096d5f724]

[whit72]

after she allegedly slappped him in an effort to revive him

Our we now slapping people in an attempt to revive them. Wow in my area where still using archaic efforts like defib and CPR.

I would have punched her too, and probably followed it up with a body slam. I think we all know the limitations of assessing responsiveness in an unconscious patient. Slapping isn't one of them.

[FredG]

I would never slap a patient, regardless of whether it was a "tap" or not. The only ways I check for responsiveness are to tap on shoulders (as taught in the old style CPR) and sternal rub/nail bed pressure.

IMO, slapping a patient in the face like that is an open invitiaion for at least a civilian complaint. If not the patient, then by a bystander.