Painful Stimuli Limits?

[StickEm]

"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."

This is what you get for slapping a pt. in this day and age.

The sternal rub is usually adequate in most cases, and I've even seen a medic apply pressure to a nailbed while no one was looking to asertain whether or not a pt was faking it. It turns out, she was, because when he did it, she yelled, "HEY! What the heck are you doing?!? Are ouy out of your mind?!?"

Nice post-ictal response from a shoplifter, eh?

Nobody was in the ambulance but us three, so let her claim that she has lost the use of her fingernail.

[spenac]

In court all you have to prove is it is the standard of care. B.... slapping someone is not considered standard of care. Most areas that I have seen you start sternum and try other areas such as running shears on bottom feet, not to cut them but see if response at extremities. I see so many posts saying trying to get person to stop faking, yes we do that, but painful stimuli is actually to determine a persons mental status. Some say should not leave any marks, a properly performed sternum rub will leave a mark.

Just the ramblings of a tired old man.

[dougd]

I just finished my basic class (yeah, I'm all wet behind the ears, I know it. ) and we were instructed not to do sternum anymore to assess for responsiveness. Anyone else being told that? I found it interesting since that was my first response when asked how to assess for response to painful stimuli.

[Michael]

my first response when asked how to assess for response

Was your first response about assessing for response the response of a First Responder? Welcome to the site!

[itku2er]

As a general rule, the method of applying painful stimuli to assess responsiveness is left up to the caregiver, but probably shouldn't include slapping, punching, kicking, nipple-biting, nose-pulling, noogies, or an "atomic wedgie".

Slapping the patient to make them come around is only acceptable if you do it while shouting "Live, damn you, LIVE!!"

'zilla

Zilla I am :shock: :shock: :shock: :shock:

:roll: :roll: :roll: :roll:

[dougd]

Was your first response about assessing for response the response of a First Responder? Welcome to the site!

Darn, I walked right in to that - and on my first post, too.

[spenac]

Zilla I am :shock: :shock: :shock: :shock:

:roll: :roll: :roll: :roll:

You know you laughed and I just bet you've tried 1 or 2 of those. :twisted:

[canuckEMT]

If the sternal rub doesn't work I go to the nailbed, if unsuccessful on that attempt with our frequent flyer unresponsives I resort to an alcohol swab in each nostril........that usually works quite well.

Anyone else other than the frequent flyers gets airway management steps after the nailbed stimulus.

[Poguemahone]

i remember when i took my EMR=EMT-B course 2 years a go i was told to shy away from the sternal rub but not that i should toss is from my inventory of trick's i prefer take index and middle finger's in hand squeeze and rub second knuckles together hurt's about as much as the pen on the nailbed

[itku2er]

You know you laughed and I just bet you've tried 1 or 2 of those. :twisted:

I will never TELL