No more sternal rubs??

COmedic17 said:
....I'm just trying to imagine in my mind how it would be possible for a ring to get in the way while doing a sternal rub... Since a ring def wouldn't be on the knuckles used..... And if it was, I wouldn't think you would be able to bend your finger all the way...
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Simple solution to that is that EMS professionals should only be wearing a watch to work..
 
COmedic17 said:
....I'm just trying to imagine in my mind how it would be possible for a ring to get in the way while doing a sternal rub... Since a ring def wouldn't be on the knuckles used..... And if it was, I wouldn't think you would be able to bend your finger all the way...
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I would think the same thing. If a ring is touching, you're already doing it wrong.

I've done sternal rubs on unconscious/unknown, only after other methods fail, and I'm not really opposed to it, other than how it looks to uneducated bystanders.
 
So pretty much what I've taken from what you all have said is that it looks bad to bystanders who don't know what you are doing and it can leave some awkward bruising. If those are the only contradictions then I'm going to keep doing it.
 
RobertAlfanoNJEMT said:
So pretty much what I've taken from what you all have said is that it looks bad to bystanders who don't know what you are doing and it can leave some awkward bruising. If those are the only contradictions then I'm going to keep doing it.
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If your boss says to discontinue a practice and offers an alternate method, you should probably just do what they say.
 
RobertAlfanoNJEMT said:
So pretty much what I've taken from what you all have said is that it looks bad to bystanders who don't know what you are doing and it can leave some awkward bruising. If those are the only contradictions then I'm going to keep doing it.
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Aside from the above comment...add on the fact that it is almost always an unnecessary method. There are better ways. Just because we can, does not always mean we should.

One of my favorite quotes and seems rather applicable here is "Training will show you 1000 ways to skin a cat. Education will show you the cat did not always need to be skinned."
 
RobertAlfanoNJEMT said:
Simple solution to that is that EMS professionals should only be wearing a watch to work..
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...or they should be wearing whatever they feel like as long as it doesn't interfere with performing their duties.
 
I personally think I would look rather silly if I showed up wearing only my watch.

Lt. Dangles

Paramedic Beaux Dangles
 
They told us about sternal rubs in EMT school, they also said those were no longer allowed by the county, for pretty much the same reasons others here listed. However our instructor decided to show us the "proper" way to do one anyhow, as in rocking your knuckles across the sternum (applying pressure with each one), vs the apparently more common technique where people simple rubbed their knuckles across the sternum like they were trying to cause an Indian burn, which in our instructors opinion, that faulty technique is what caused the problems to get it banned.

At least for us on the BLS side, the only two officially approved techniques for testing painful stimuli response is the finger nail bed press and (I'm forgetting the technical name) placing a pen between the patients knuckles and squeezing them together. I've seen Paramedics here also use trap squeezes and other techniques as well, so that might only be BLS restricted to those two.

akflightmedic said:
I personally think I would look rather silly if I showed up wearing only my watch.
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Why is your watch that silly looking? :P Just need to go full whacker and get your badge tattoo'd on your chest and you'll be good to go, it's your summer uniform option right?

Remi said:
They don't call me "big guy" for nuthin'...
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The real question is are they looking below or above the waist? ;)
 
RobertAlfanoNJEMT said:
So pretty much what I've taken from what you all have said is that it looks bad to bystanders who don't know what you are doing and it can leave some awkward bruising. If those are the only contradictions then I'm going to keep doing it.
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Yea I mean leaving some "awkward bruising" is totally fine, especially when there are other ways that don't, right?
 
Tigger said:
Yea I mean leaving some "awkward bruising" is totally fine, especially when there are other ways that don't, right?
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It's not that I am intending to leave the awkward bruising but I'm not hyper analyzing everything I do to the smallest degree.. In the heat of the moment if the first thing that comes to my head as a source of painful stimuli is a sternal rub, I'm not worried about what kind of bruising they will have, I'm worried about determining their LOC and what to do with that information.
 
RobertAlfanoNJEMT said:
It's not that I am intending to leave the awkward bruising but I'm not hyper analyzing everything I do to the smallest degree.. In the heat of the moment if the first thing that comes to my head as a source of painful stimuli is a sternal rub, I'm not worried about what kind of bruising they will have, I'm worried about determining their LOC and what to do with that information.
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Or maybe practice a way that accomplishes both objectives so that it's readily available "in the heat of the moment".
 
RobertAlfanoNJEMT said:
In the heat of the moment if the first thing that comes to my head as a source of painful stimuli is a sternal rub, I'm not worried about what kind of bruising they will have, I'm worried about determining their LOC and what to do with that information.
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That's what education, training and practicing is for. So that "in the heat of the moment" you natural reaction/response is to do what is right per your protocols, not per your feelings.
 
RobertAlfanoNJEMT said:
It's not that I am intending to leave the awkward bruising but I'm not hyper analyzing everything I do to the smallest degree.. In the heat of the moment if the first thing that comes to my head as a source of painful stimuli is a sternal rub, I'm not worried about what kind of bruising they will have, I'm worried about determining their LOC and what to do with that information.
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Turns out that's not how being a professional works. You don't get to choose what you think is best in the face of contradictory evidence.

Also you should be worried about a causing unnecessary bruising, there's that whole "first do no harm thing."
 
COmedic17 said:
....I'm just trying to imagine in my mind how it would be possible for a ring to get in the way while doing a sternal rub... Since a ring def wouldn't be on the knuckles used..... And if it was, I wouldn't think you would be able to bend your finger all the way...
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Presumably the provider in question used his hand in a closed fist and just ground down his MCP knuckles instead of the more distal ones.

I have had partners that wear rings, though the women with rocks on them tend to turn them inward when gloves go on.
 
I prefer supraorbital pressure, i get decent response from that and nothing damaging

COmedic17 said:
Pinch their trap and put ammonia salt under their nose.
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You still use ammonia inhalants?!
 
First learned sternal rub 3 years ago, and learned at the same time that it was phased out. I've never done it, but even today nurses in the ED still do, usually giggling away. The docs don't, interestingly enough. I've given up on saying the whole "You know, there are other ways to do that...".

We'll bust out ammonia salts if a doc wants it, with high confidence that this patient just doesn't want to wake up. Never seen it fail when appropriately used (ie, dead people don't wake up).
 
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