I love it when someone (usually young) comes in claiming to not be able to feel and or move their legs after a trivial injury. Almost invariably I start out with “Can you feel this?” (and gently touch the supposedly paralyzed limb) – of course the answer is “no”. “Can you move your leg?” Of course not. Then I try with a little harder pressure and they also answer in the negative. Finally I pinch the crap out of them and watch their facial expression. Sometimes they are trying to hold back a look of pain and bite their lip or breathe deeply in before they start to sweat. “Nnno!” they may utter obviously through the pain. Other times they just yelp and yank their leg away. “Hey!!! That hurts like Hell!!!”.
Yeah, I thought so. You are not paralyzed and you are not getting any Dilaudid.
Ha! We use the sternum rub when some mook pulls the unconscious act to avoid going to jail. Although one guy actually faked it right up to the NG tube in the ER. He couldn’t hold back the tears during that.
Why would you need Dilaudid if you can’t feel the limb?
Crazypants!
My son has HypoKPP. You could pinch the hell out of him and he’d feel it, but still wouldn’t be able to move away. Stumped his doctors at first, then they realized that his sensory neurons weren’t affected, just the Na/K pumps in the muscle cells themselves. Not that he’d need Dilaudid anyway, just a shit ton of K+.
How about finger up the bum if if their legs that are paralysed that will make them jump rofl!!
I was once triaging a middle age female with ab pain on a crazy crazy night. I think she saw the wait, and decided to “faint” sitting up perfectly in her wheelchair while I was triaging. She woke up nicely when I pressed my pen hard on her thumbnail- in fact, she about jumped out of the chair.
Her husband was like- What did you do? I said, oh just testing her reflexes to make sure she’s still conscious. He just kind of gave me this knowing look, like, yeah I know she’s FOS
Yes ma’am, you’ll be fine to wait in the lobby.
Like Meghan’s “testing the reflexes to make sure she’s conscious” response. I’ll have to remember that one.
I usually take a sterile swab and lightly touch their leg several times.
“You feel that?”
“No.”
Then I suddenly poke the sharp end of the swab into the sole of their foot.
99 times out of 100 they pull their leg back and yell “ouch” followed by various other colorful language.
But at least I cured their paralysis.
Couldn’t you just Train of Fours them to disprove paralysis?
I think some brain death type testing is good for “unconscious” people…let’s take a look at those corneal reflexes and see if they’ll stay “unconscious”. Maybe some cough/gag testing as well?
I don’t have that neato device but maybe I should.