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Faking or not faking? That is the question.


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When we have a faker we often push 2cc's of Alcohol 70% up their nose. Nobody can resist that.

HAs anybody else tried that?

Ummmmmmmmmm NOOOOOOOOOOOOOOOOOOO. Surely you are joking?

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When we have a faker we often push 2cc's of Alcohol 70% up their nose. Nobody can resist that.

HAs anybody else tried that?

I am firm believer in painful stimuli but not torture, that is close to torture. How long you been in EMS harold1? A good lawyer could win a civil suit on that one. That isn't taught in any EMS class I have set in nor when I called my friend that teaches his reply was "terr I wouldn't even do that to your ex." so that tells me that is bad juju. What if they are allergic to alcholol? You have just did harm to your patient, some times allergies just pop up. You really should think this through some more before you do it again. And my advice is this if you want to do this then you need to go back to playing EMT and leave the real life saving to the professionals.

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I think I know what happended on this guy. He said he couldn't breathe, started breathing heavy, then stopped breathing, right?

I think he had an anxiety attack (because he's drunk off his ass), started hyperventilating, then passed out and became apneic because he blew his PaCO2 down REAL low. The apnea in reality is a compensatory pause. When their PaCO2 climbs back up, they'll start breathing again.

So, no. He wasn't faking, but it wasn't serious either.

However, you have to treat what you see. You guys did a good job.

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2 cc's of 70% alcohol introduced into anyone's nares is ASSAULT. Not a way to sort out fakers, not a way to ascertain level of responsiveness- it is ASSAULT.

You can cause damage to their mucous membranes, they can inhale the stuff, you could trigger an asthma attack in an individual who is sensitive to chemicals (like myself), you could cause a bloody nose... WTF happened to DO NO HARM, even to the arse you know is faking because this is the 18th time you've seen him in 2 weeks?

What are you going to do when you think you have a faker but you really have a psychological emergency instead, that is manifesting as faked medical symptoms? How will you justify your actions when that person recovers and remembers the intense pain that was completely unnecessary, and hauls you into court? What if your person is really and truly unconscious but just a weird patient, and you inflict damage with your little alcohol trick?

That sounds like a frat boy trick, rather than the actions of a competent and ethical medical provider.

Go ahead. Try it yourself when you're sick and feel like crap. See how well YOU like having that stuff up your nose! Even my brother, who's only a 17 year old First Responder, immediately said "Oh no! Lawsuit city!" when I mentioned your idea to him.

Wendy

CO EMT-B

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2 cc's of 70% alcohol? I'd agree, why not just smack them with a bat to see if they stop playing with you? Maybe you could just avoid that whole deal and transport them prone on a LBB.............just kidding, that was for Wendy, come on I'm kidding!

Seriously tho, the alcohol......NO!

I have done the "arm trick", doesn't always work for those who have been through it enough.

I have also used the "eyelash trick", and like it.

I have also done the "rolling the pen on the nail beds trick", it's ok but not 100%.

I have done the "airway trick" both basic and advanced (never fully intubated), Now it's more of a threat than any thing to the obnoxious a**hole (drunk) when they are telling me they want to kill my family.....

The point of the matter here is that no matter what, your going to treat what you are presented with as stated numerous times. Doing NO harm is the key, and I will agree that looking foolish for buying in to their little game is always going to be considered error in favor of the Pt down the road. We are not here to pass judgement, and punish Pts for their actions, no matter how frustrated we may get. Do the job, and let the Drs decide how to follow through with their extended care (hospitalization or psych admission).

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I can completely understand the frustration of dealing with "fakers". We actually deal with a male and female about every three days. One has pseudoseizures and the other suffers from breathing difficulty. As frustrating as it is, we respond and transport them. We write a detailed report and give the doc an even more detailed report. With our assistance, the female was admitted for 90 days to a psychiatric treatment center. When the male chooses not to cooperate, he is threatened with being deemed a vulnerable adult. He's been much better lately.

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