After I wrote a recent article on the benefits of the face flick for assessing level of consciousness, I received a string of questions and commentary on the effectiveness of another, more well known assessment for unconsiousness - the hand drop test.
The hand drop test is considerably more well known than its cousin the face flick and it remains a fairly reliable, though somewhat controversial test.
There’s a reason why the hand drop test is so well known. It tends to work. It’s a clever and reliable way to force a patient to make a decision and reveal their true mental status.
When done properly it’s harmless and does not require forcing pain or noxious stimuli on the patient. It also has the advantage of being appropriate to perform in front of family and loved ones. Unlike the face flick which is a bit to obnoxious for public consumption, the hand drop can be performed anywhere and looks like a fairly standard neurological test. If you don’t have this one in your tool box yet, it’s time to add it. If you do know it, let’s review it. There are some subtle elements to doing the hand drop test accurately and safely.
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Posted 1 year, 2 months ago at 6:00 am. 7 comments
Did you ever watch the old Star Trek TV show? No of course you didn’t, but this is just you and me talking 
here right? OK, remember when something would threaten the ship. The captain’s first response was to say, ”Go to red alert.” or “Set condition red.” and the lighting would change and a little alarm would sound. That funky shaped light on the front console would start pulsing red. Everyone knew to treat the situation with importance.
I don’t know about you, but I have a list in my head of assessment findings that cause me to shift mental gears into condition red. I don’t need to say anything overly dramatic, but everyone on who works with me can tell when I’ve switched gears to condition red.
For one thing, I start moving just a bit faster than my usual casual pace. I delegate tasks in a laundry list fashion. “I’m going to need an O2 mask. Lets get the pram to the door and bring a stair chair up here. Jesse strip me a line in the rig and check the status of Swedish ER.” The patient may not know the difference, but people who work with me can tell that I’ve set condition red.
Here are a few of the assessment findings that send off alarm bells is my head.
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Posted 1 year, 3 months ago at 6:00 am. 17 comments
