The other day I was on a typical etoh call. On arrival it started just like the many etoh/man down calls I have done. The pt was caox3 with no complaints other than he drank to much and smoked to much weed. The pt took a nap on the side of the st and someone called 911.the pt wanted to go to the hospital and wad cooperative. When my assessment was done and we were transporting, the pt stopped responding to my questions. I got nervous at first but it didn't seem right. I did a sternAL rub and got no response. I checked my abcs and pt had a pulse and was breathing 10 tomes a min. It still didn't feel right so I did the hand drop technique my medic instructor told me about which sounds bad but you put there hand over there face and drop it. If they are conscious people tend to move there hand so as not to hit themselves in the face. This pt failed the test and not only ounce but three times he moved his hand. So it would land next to him. I told the pt that if he didn't wake up I would have to place an npa. He didn't so I did. When I got to the hospital my partner knowing what was going on yelled narcan tIme and the pt nearly jumped off the stretcher. Which is really funny because the pt didn't seem to be on any opioits he had reactive and non pinpoint pupils. The pt then bragged about pretending to be dead lol. Has this ever happened to any one? Was the npa to far? Any other tips on fooling even the best opossums?
Playing Opossum
- Thread starter dannyd
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DesertMedic66
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If they want to fake it that's fine by me. It allows me to get my paperwork finished and it's a quiet transport.
I'm not a fan of the hand drop test. Pressure on their nail bed with a pen has never failed for me.
If they need an NPA then I will place one. If they don't need one then it's not indicated and I wont place it.
I'm not a fan of the hand drop test. Pressure on their nail bed with a pen has never failed for me.
If they need an NPA then I will place one. If they don't need one then it's not indicated and I wont place it.
SeeNoMore
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The "hand drop test" always seemed absurd to me. Is this an actual technique outside of EMS? I agree that painful stimuli like pressure on the nailbed is more useful. In any event, I don't try and fool anyone. If someone becomes unresponsive I perform a reassessment ( s/s of a seizure, blood glucose, psych, overdose etc) and evaluate the adequacy of their respiratory effort and airway patency. If they need airway management of some kind they will get it. If they wake up and ask me to stop, I will gladly do so.
Drunks are usually drunk, so they passout and are hard to stimulate. Or like you said I have patients fake crap all the time. From seizures to being passed out. First one is annoying, second one is awesome.
I would not have placed an NPA though, No point, he is supporting his own airway. Either pressure points or "hey man if you do not wake up the hospital is going to have to stick a tube in your penis." Works all the time, if not, then the hospital will actually stick a tube in their penis.
I would not have placed an NPA though, No point, he is supporting his own airway. Either pressure points or "hey man if you do not wake up the hospital is going to have to stick a tube in your penis." Works all the time, if not, then the hospital will actually stick a tube in their penis.
SeeNoMore
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I like your style. It's direct, honest and provides a reaonable incentive to stop pretending to be passed out.
akflightmedic
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I once thought someone was faking...they passed all the tests you listed. Sadly, they had a brain bleed and died.
I judged the patient on past encounters, where we picked him up and what I thought I knew was wrong with him. Do not jump in every rabbit hole.
I judged the patient on past encounters, where we picked him up and what I thought I knew was wrong with him. Do not jump in every rabbit hole.