Oh man

[ClarkKent]

From that I have been reading by AJ is if you do more than just checking the ABC in this situation would be assaulting the pt even when the pt is unconscious/unresponsive. I was just making sure I understood what he was trying to get across and not misreading it. But if an EMT at any level uses a sternum rubs can be an assault on the pt??

I am lost, what is an “OP” or a “MRF” stand for?

 

[EMTCop86]

We're not supposed to use sternum rubs?

Oh?

Nope, it's barbaric. Use the trap squeeze.

 

[EMTCop86]

I am lost, what is an “OP” or a “MRF” stand for?

OP= Original Poster (the one who started the thread)

MFR, not MRF= Medical First Responder

 

[traumateam1]

From that I have been reading by AJ is if you do more than just checking the ABC in this situation would be assaulting the pt even when the pt is unconscious/unresponsive. I was just making sure I understood what he was trying to get across and not misreading it. But if an EMT at any level uses a sternum rubs can be an assault on the pt??

I am lost, what is an “OP” or a “MRF” stand for?

I don't know if it's assualt.. I guess it comes down to your county/area or whatever. It's just an unnecessary procedure, especially a male doing this on a female. There are better procedures you can use to assess AVPU. Such as the trap squeeze or nailbed pressure.

OP: Original Poster
MFR: Medical First Responder

 

[ClarkKent]

Now I am getting it, thank you traumateam1. You are very true, if a male MFR (see I am learing new things) does a sternum rubs, it could look sexual to a friend of the pt and then you are $^%*. Now I understand why it is not longer used. Thank you for opening my eyes to what I was blind to.

 

[Hockey]

Tarp squeeze?

 

[ClarkKent]

Tarp squeeze?

Trap = Trapezius muscle. The Spock move
(posted by AJ)

 

[EMTCop86]

Tarp squeeze?

Grasp the trapezius muscle in between your thumb and index and middle fingers and then squeeze and twist.

 

[amberdt03]

Grasp the trapezius muscle in between your thumb and index and middle fingers and then squeeze and twist.

hurts like h*ll

 

[Shishkabob]

The heck AJ? Not using sternum rub / nailbed?

Sorry, but I was taught 3 different moves to elicit a response during the pain portion; sternum rub, nail bed, and trap muscle. Just because you don't agree with it doesn't mean the school is a bad school, especially considering it's one of the best here in Texas.

And on top of that, protocols > your views anyday. If my protocols allow me to do something, I couldn't care less what you think is barbaric. I'm doing what I have to do.

 

[reaper]

That's the way to debate!

Do I still use the Sternal rub? Yes! I also use nail beds, traps, and ear lobes. It is what ever I get a response to and can access. Not all Pt's respond the same. I have seen Pt's that have no response to the nail bed or traps, it does not bother them at all.

Sternal rub is only barbaric when used improperly. We could all say that compressions are barbaric, but still useful.

As I said, every pt is different. Use what works for that pt!

 

[Sasha]

The heck AJ? Not using sternum rub / nailbed?

Sorry, but I was taught 3 different moves to elicit a response during the pain portion; sternum rub, nail bed, and trap muscle. Just because you don't agree with it doesn't mean the school is a bad school, especially considering it's one of the best here in Texas.

And on top of that, protocols > your views anyday. If my protocols allow me to do something, I couldn't care less what you think is barbaric. I'm doing what I have to do.

He isn't saying don't check your response to pain, if you are the medical provider responding to the call. Don't check it if you're a bystander who came upon an unresponsive person. The most you're supposed to do is shake them around "HEY HEY! ARE YOU OKAY!?!?" not grinding your knuckle into their sternum.

You, personally, have no reason to asses their AVPU further than verbal, as a bystander. It can be viewed as battery by a friend or family member off on the side, and technically it is. Kempo flubbed up. It should have been a "Hey! Are you okay?" and call 911, not sit around pinching her arms and grinding his knuckles into her sternum. And if you MUST asses for pain, do it once. Not four times.

 

[EMTCop86]

Since we are on the topic of painful stimuli, I thought I would share this article with you. I found it very interesting.

http://www.emsresponder.com/print/EMS-Magazine/Beyond-the-Basics--Patient-Assessment/1$3685

 

[AJ Hidell]

Sorry, but I was taught 3 different moves to elicit a response during the pain portion; sternum rub, nail bed, and trap muscle. Just because you don't agree with it doesn't mean the school is a bad school, especially considering it's one of the best here in Texas.

Dude, you've been to a grand total of ONE EMT school in your short life. How would you know whether it is one of "the best" or not? Because they told you so?

Nail bed pressure is not central stimulation. A competent GCS exam requires central stimulation for the motor assessment. If you're using nailbed pressure, you aren't doing a competent assessment. They didn't teach you supraorbital pressure? They didn't teach you TMJ pressure? They didn't bother to teach you two accepted methods of central stimulation, but they taught you one peripheral method, and one outdated central method that is banned in many organizations instead? Clearly your "one of the best" school has some serious shortcomings.

And on top of that, protocols > your views anyday. If my protocols allow me to do something, I couldn't care less what you think is barbaric. I'm doing what I have to do.

It is obvious that you're all about what you're "allowed to do" and couldn't care less about what you should do. There is a lot more to medical practice than the extremely abbreviated knowledge base you received in EMT school. There's a big world of information out here that you -- and most of your instructors -- are wholly unaware of. That's why EMS stays a good decade behind the rest of the medical world. It takes that long to beat old bad habits out of the burnouts that are teaching EMT schools, and don't have any more education than you do in the first place. If you would start doing a lot more listening than mouthing off here, you could acquire some of that knowledge for yourself and improve your practical competence. But first you have to get past this annoying rookie mentality that your little blue patch means that you already know everything, and that your local protocol book is the Holy Grail of medicine.

 

[Ridryder911]

Another amazement is how immature in medicine medics can be. Anyone with any little experience and common sense realizes that one can inflect noxious stimulus without causing harm and as well recognize and better approved methods. No matter (protocol or not) one should recognize methods that is recognized to be in the best behalf.

Does one administer the full D50w rapid IV because one can or does one administer D10w and obtaining the same results, without causing rebound, pain to the patient? Although, the protocol states to ....."administer D50w"..

Inexperience has not taught those that protocols are "suggestions" and guidelines. Any service worth anything should not have to have protocols describing on how to perform each step and procedure on all procedures. Such protocols are for those that the physician does not trust or realizes their poor medical education level. I have to admit, I had never heard of protocols of how to establish responsiveness. It has always been a given of having the understanding and knowledge of how to properly check and assess such.

Just because it is stated or quoted does not make it right. Pinching or twisting the nipple is quoted in several texts; but would we ever suggest such? Why? Because it is inappropriate and not warranted alike sternal rub.

Those that really know medicine; can establish their LOC by assessment of the neuro system. Does one really have to play in their game of <LOC? I much rather whisper into their ear that I medically know that they are awake and to stop such behavior. Amazing; I will see a drastic & improvement of change. Recognizing cornea reflexes, eye lid fluttering, arm drop test, etc.. that are non damaging are just effective.

We need to stop and ask ourselves; what is the reason for performing any of the test or procedures? What or if any of the results changes our treatment and in the best interest for the patient. Remembering, the procedure(s) is for the patients sake not ours.

I personally never cared for "cowboy medics". Those that will either go beyond or interpert the protocol to the letter to be able to do something not for the sake of the patient but rather for their own poor underinflated ego.

Remember, even if you are following an approved protocol damage can occur. When this does; one can and maybe held accountable. This does not exempt one from such even if " you were doing, what you have to do".

R/r 911

 

[RDUNNE]

My MFR Instructor was talking about checking responsiveness last night, and was very adamant about us using the sternum rub rather then anything else, and it created quite a heated debate in the class. Personally I think the trap squeeze is a much better method. (not that I'm in any place to make that decision.)

 

[Chelle]

One of the hardest concepts for EMS n00bs to understand is that you don't always have to "do something". One of the weaknesses of EMT education is that it is so skills-based that the EMT is left with the impression that there is always some "skill" s/he must be performing on every patient. What results is what we see here, which is people doing things just to be doing things, without really understanding what they are doing or why.

Quotes like this are the reason I am here.

Snatching the pebble from your hand.............................

 

[Ridryder911]

My MFR Instructor was talking about checking responsiveness last night, and was very adamant about us using the sternum rub rather then anything else, and it created quite a heated debate in the class. Personally I think the trap squeeze is a much better method. (not that I'm in any place to make that decision.)

Your instructor needs to return to school, invite them here to discuss if they don't agree.

R/r 911

 

[AJ Hidell]

Quotes like this are the reason I am here.

Snatching the pebble from your hand.............................

And quotes like that are the reason I am here! It took me over three decades, and making every mistake in the book to come to the level of enlightenment that I have attained. If I can help one person get there just a little faster and easier than I did, it makes it all worth it. Thanks!

 

[Sasha]

And quotes like that are the reason I am here! It took me over three decades, and making every mistake in the book to come to the level of enlightenment that I have attained. If I can help one person get there just a little faster and easier than I did, it makes it all worth it. Thanks!

Liar. You're here because you like the drama.