Oh man

FutureParamedic609

Forum Crew Member
34
0
0
I just have to ask, what is OD stand for/mean?

Please excuse me, I'm just wanting to know acronyms, etc. since I can't be an EMT yet. Just future references ;)
 

Shishkabob

Forum Chief
8,264
32
48
And if not, can it be legally justified? And if not, is that not assault (or whatever term your jurisdiction assigns to non-consensual bodily contact)?



Now, correct me if I'm wrong... but you're from Texas.

Texas has implied consent.

Implied consent means if a pt is unconscious/unresponsive/ not in the decision making frame of mind, EMS can do what it has to do to correct the situation.



How is determining AVPU, from an MFR, assault in any way?
 

8jimi8

CFRN
1,792
9
38
i just have to say. it sounds like the story changed right in the middle of the post.

a. no one knows your friend
b. why can't you post the details then, it would never get back to her without identifying information?
c. no one really knows you, so its almost double blind.
d. if you just want us to drop it, then stop posting in this thread.
e. if you didn't want us to ask questions about it then why did you bring it up in the first place?
f. i have to agree with Ms.Medic, you really sensationalized your role in this whole epic.
g. i don't really care that much, but it kind of makes you look bad to be hanging out with people who are od'ing. so if you want to save face then explain the situation.
 

amberdt03

Forum Asst. Chief
503
3
0
Now, correct me if I'm wrong... but you're from Texas.

Texas has implied consent.

Implied consent means if a pt is unconscious/unresponsive/ not in the decision making frame of mind, EMS can do what it has to do to correct the situation.



How is determining AVPU, from an MFR, assault in any way?


determining an AVPU is not going to correct the situation. What AJ was saying was there was no need to do a sternal rub. That is not going to cure anyone. All that needed to be done is to make sure her airway was intact, and it didn't seem like there was any problems with her airway. so with that being said, if he was truly worried, he should have called 911 and just monitored her ABCs until she woke up, or help arrived.
 

Sasha

Forum Chief
7,667
11
0
How is determining AVPU, from an MFR, assault in any way?

How does determining AVPU correct the situation? When you teach CPR you don't teach them to do a sternal rub, you teach them to shake the patient "HEY HEY! ARE YOU OKAY?" because for a lay person, and he was functioning as a lay person, all you need to know is the person isn't waking up when you shout at them.

And even EMTs don't sit there and keep testing for response to painful stimuli. He tested for it FOUR times. Two trap squeezes, which I have no idea what that is, and two sternal rubs. Why? Did he dose her with Narcan or soemthing between, or just sit around wondering if he did it right?

My guess is if a sternal rub woke her up and solved the problem, she wasn't really OD'd.
 
Last edited by a moderator:

Shishkabob

Forum Chief
8,264
32
48
I totally agree that the amount of test was excessive, but that's not what is being argued. What's being argued is that even a SINGLE AVPU test would constitute as assault/battery, and I am pretty sure not a single DA in this country would prosecute.


True, doing an AVPU test would not cure someone, but it would help determine the seriousness of their condition.

After he stated that he did 1 AVPU test with no response, he should have been on the phone.







PS-- I'm with Sasha, I don't know what a trap squeeze is. I'm guessing he was copping a feel. =P
 
Last edited by a moderator:

AJ Hidell

Forum Deputy Chief
1,102
3
0
PS-- I'm with Sasha, I don't know what a trap squeeze is. I'm guessing he was copping a feel. =P
Trap = Trapezius muscle. The Spock move.

For an MFR, AVPU is nothing more than something to put into your report to the hospital. He wasn't reporting to the hospital. I am waiting to hear exactly what he was doing. No technique can be justified by, "it's just what we always do". You need to be able to articulate exactly what the purpose of the technique was, and how it was beneficial to the patient. Otherwise, you're just assaulting them.

An unconscious patient gives "implied consent" for medical attention. You'd be very hard pressed to justify a sternal rub or trap squeeze as medical attention, coming from a MFR who was acting out of his scope.
 

8jimi8

CFRN
1,792
9
38
It is very painful. I have had it performed on me during EMS Scenario Training, where I was acting as an unresponsive diabetic. I used it to assess responsiveness on a woman from whom we had withdrawn life support. She actually opened her eyes. *Now, I was not being cruel, She was unresponsive to a sternal rub and I was actually doing a clinical assessment*
 

emtfarva

Forum Captain
413
2
0
i like the pen pressed to the nail bed. it doen't leave a mark either
 

Hockey

Quackers
1,222
6
38
facepalm.jpeg

Thank you Nomo ;)
 

AJ Hidell

Forum Deputy Chief
1,102
3
0
Show me an EMT school that is teaching the sternal rub or nailbed pressure as legitimate medical techniques, and I'll show you a school that sucks. It's really sad how lost in the 1970s so many instructors are. No wonder no other profession takes us seriously.
 

8jimi8

CFRN
1,792
9
38
I was in the ICU the other day and freaking neurologists were going CRAZY trying to make this woman localize / withdraw pain. One was using a pen to CRUSH her fingers and the other one was using the handle of a metal reflex hammer.

Poor lady was just having a hard time waking up from propofol / (? i can't remember the other pain med she was on - on her PCA) and had developed a suspicious "lack of moving her upper extremities" after having a spinal fusion from T2 to S1

poor lady we turned off the propofol for like 40 minutes and as soon as she started coming to she starting biting / bucking the vent and trying to reach up to extubate herself. Poor thing had such a sensitive gag reflex she kept puking everytime she got even moderately close to conscious.
 

fortsmithman

Forum Deputy Chief
1,335
5
38
Show me an EMT school that is teaching the sternal rub or nailbed pressure as legitimate medical techniques, and I'll show you a school that sucks. It's really sad how lost in the 1970s so many instructors are. No wonder no other profession takes us seriously.

Here in Canada we are trying to get all EMS programs accredited by the Canadian Medical Association. Maybe it's time that the American Medical Association starts to accredit EMS courses in the USA. If that were to happen then maybe EMS would be treated more seriously.
 

AJ Hidell

Forum Deputy Chief
1,102
3
0
It's happening. CAAHEP has taken the task of accreditation of paramedic schools, as they have been doing for other healthcare disciplines for years. They are endorsed by the EMS physicians in that mission, so it has credibility. Unfortunately, all the fly-by-night tech schools are whining and crying foul about the process, as it threatens the gravy train they have been on for the last thirty years. But in the next couple of years, they will either have to get their programs in line or die.
 

traumateam1

Forum Asst. Chief
597
1
0
Show me an EMT school that is teaching the sternal rub or nailbed pressure as legitimate medical techniques, and I'll show you a school that sucks. It's really sad how lost in the 1970s so many instructors are. No wonder no other profession takes us seriously.

That is one of the first things we are to do. First verbal and if no response then we are to do the trap squeeze or nailbed pressure.
However we never do sternal rubs.. that's just asking for trouble in my books... well so it hacking off an arm with an axe :p
 
Last edited by a moderator:

ClarkKent

Forum Lieutenant
208
1
0
Ok I know that I am new and all, but thought that you have to find out if the is just unconscious (sleeping) unresponsive (just got knocked out) by using pain to determine if medical help is even considered necessary. I understand that the sternal rubs is not used (I have only been told to use that on newborns) but the trap squeeze and the nail bed pinch is being used in my class.

What I am trying to get it is if, you are off duty, in street clothing, walking home, and you see a person that unconscious next to a step going into a building, all that I can do is check his ABC’s and call 911. I thought that you would have done your AVPU to make sure he was not just taking a nap.

Sorry if I am looking into this topic to much, but I want to make sure I fully understand where this is going?
 

traumateam1

Forum Asst. Chief
597
1
0
Ok I know that I am new and all, but thought that you have to find out if the is just unconscious (sleeping) unresponsive (just got knocked out) by using pain to determine if medical help is even considered necessary. I understand that the sternal rubs is not used (I have only been told to use that on newborns) but the trap squeeze and the nail bed pinch is being used in my class.

What I am trying to get it is if, you are off duty, in street clothing, walking home, and you see a person that unconscious next to a step going into a building, all that I can do is check his ABC’s and call 911. I thought that you would have done your AVPU to make sure he was not just taking a nap.

Sorry if I am looking into this topic to much, but I want to make sure I fully understand where this is going?

Your not looking into it to much, the issue (with this scenario anyways) isn't about doing an AVPU check.. rather how the AVPU check was done. The OP used a sternal rub, which isn't used by EMS and definitely not by the lay person. If you approach an unresponsive person as a lay rescuer you should be on the phone with 9-11 dispatch, as you can always cancel them if needed. Gently kick their feet while yelling HEY HEY, ARE YOU OKAY??? (don't do this if their is an MOI suggestive of trauma.. as you want them to lay as still as possible). Then you go from their reaction. If they don't do anything than maybe try a painful stimuli (trap, nailbed) and then continue on with ABCs.

The reason I'd gently kick the soles of their feet is because I don't wanna have my face down near them when they wake up and first instinct is to clock you a good one.
 
Top