DwayneEMTP Posted February 19, 2012 Share Posted February 19, 2012 Like I mentioned above, it seems to me that most of the 'checks for responsiveness' are providers not looking for information but instead visiting pain on someone that they feel is faking, a victim of their own poor choices, or shouldn't have called in the first place... One of the things that makes me want to go postal in EMS is hearing a provider screaming, "Don't you hit me! Keep your hands down!! Don't you hit me again!" regarding a drunk, hypoglycemic, postictal pt that is randomly flailing, and yet moments later grinding the hell out of their sternum when they appear unresponsive. So violence is ok when provider delivered, but not when from the patient? Craziness... Dwayne Link to comment Share on other sites More sharing options...
Happiness Posted February 22, 2012 Share Posted February 22, 2012 How do you explain the epistaxis running into thier unprotected airway? First do no harm! An NPA insertion will sort out the fakers..... If it is that important to you that you are the one to expose thier fakeness. So first not one person has ever hit their face and cause an unprotected airway, next the last time I used a OPA and said it here I got slammed. As for needing to know about someone faking, I just like to know as I do know a medic that was caught off guard with a faker (a good faker at that) I keep waiting for the decade when the stupid arm drop test is relegated to whackerdom. Providers still bring it up, usually with a stupid grin cause they are oh so smart. I touch the eyelashes. The corresponding reflex movement of the eyelid is enough to reassure me that my patient is protecting their airway. Its not that I am a wacker it was something I was taught and have never been told not to do it. I do know about the eyelashes but it isn't what comes to mind I guess, maybe I will try that next time. We all have different idea's and I have never harmed anyone in doing the LOC checks, I personally think the sternum rub is a bit barbaric but if it works it works. Link to comment Share on other sites More sharing options...
DFIB Posted February 22, 2012 Share Posted February 22, 2012 So first not one person has ever hit their face and cause an unprotected airway, next the last time I used a OPA and said it here I got slammed. As for needing to know about someone faking, I just like to know as I do know a medic that was caught off guard with a faker (a good faker at that) Its not that I am a wacker it was something I was taught and have never been told not to do it. I do know about the eyelashes but it isn't what comes to mind I guess, maybe I will try that next time. We all have different idea's and I have never harmed anyone in doing the LOC checks, I personally think the sternum rub is a bit barbaric but if it works it works. The sternum rub and the arm drop have two different diagnostic purposes. I like the arm drop if i think they are faking. It is way obvious and has never failed me. Link to comment Share on other sites More sharing options...
chbare Posted February 22, 2012 Share Posted February 22, 2012 Is our goal to find personal satisfaction in sorting out fakers or are we interested in something a bit more important. Arm to face drop, eyelash reflexes and so on have little relevance IMHO. Can the patient breath, are they swallowing, are they managing their secretions? The ability to spontaneously protect the airway is probably much more important than writing down a "P" on the PCR. Food for thought anyway. Link to comment Share on other sites More sharing options...
Kiwiology Posted February 22, 2012 Share Posted February 22, 2012 im only interested in finding out what level of response my patient has; give them a bloody good sternal rub Link to comment Share on other sites More sharing options...
DFIB Posted February 22, 2012 Share Posted February 22, 2012 Is our goal to find personal satisfaction in sorting out fakers or are we interested in something a bit more important. Arm to face drop, eyelash reflexes and so on have little relevance IMHO. Can the patient breath, are they swallowing, are they managing their secretions? The ability to spontaneously protect the airway is probably much more important than writing down a "P" on the PCR. Food for thought anyway. You make a good point but are you saying that the LOC is not relevant to you in your assessment? Link to comment Share on other sites More sharing options...
chbare Posted February 22, 2012 Share Posted February 22, 2012 Not at all, but let us look at the big picture instead of isolated, faker litmus tests. 1 Link to comment Share on other sites More sharing options...
mobey Posted February 22, 2012 Share Posted February 22, 2012 So first not one person has ever hit their face and cause an unprotected airway, Is this scientific? or just you're experience? As for needing to know about someone faking, I just like to know as I do know a medic that was caught off guard with a faker (a good faker at that) What was the negative outcome for the patient? Its not that I am a wacker it was something I was taught and have never been told not to do it. I do know about the eyelashes but it isn't what comes to mind I guess, maybe I will try that next time. I agree.... You are NOT a whacker We all have different idea's and I have never harmed anyone in doing the LOC checks, I personally think the sternum rub is a bit barbaric but if it works it works. I don't wanna bust you're perverbial balls here, but just a reality check for ya: A sternal rub is barbaric yet you are advocating dropping a 7lb (adult) piece of bone and meat on thier face while they lye there completely defenseless and entrusting thier well-being and dignity to you? Link to comment Share on other sites More sharing options...
Happiness Posted February 22, 2012 Share Posted February 22, 2012 (edited) Is this scientific? or just you're experience? This is by experience and Yes I have used this technique but it is not the only technique I use. Not once have I decided to use it with out really thinking this person was faking and not once have I had a person hit themselve in the face. What was the negative outcome for the patient? No negative outcome for the patient, but the patient and the medic ended up rolling around in the back. So therefore I think it is very important for the medics safety they know if a patient may be faking. I agree.... You are NOT a whacker Why thank-you I don't wanna bust you're perverbial balls here, but just a reality check for ya: A sternal rub is barbaric yet you are advocating dropping a 7lb (adult) piece of bone and meat on thier face while they lye there completely defenseless and entrusting thier well-being and dignity to you? Oh don't worry about my balls, I am here to learn what I can from others. Even though there are those that dont agree with the arm drop I feel it does have a place. I am not saying you use this the little old lady or the 10 year old that fell off of a bike, this in my opinion is used when you think for what ever reason (a gut feeling) you need to know if a person is faking. Edited February 22, 2012 by Happiness Link to comment Share on other sites More sharing options...
chbare Posted February 22, 2012 Share Posted February 22, 2012 With all the dropping hands onto faces and sternum rubs, I cannot help but to see the following, except substitute her with a person who may be unresponsive: Link to comment Share on other sites More sharing options...
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