Generally on a level of alertness/consciousness scale, we rank people by A – Alert, V – Verbal, P – Pain, U – Unconscious.
If a patient is not alert and easily rousable, we’ll move on to the next stage and attempt to rouse the patient with loud sound (like raising our volume), if that doesn’t work then it’s escalated to causing pain to illicit a response.
EMT here. Rubbing does not “wake them up”. The maneuver is used in order to assess the consciousness of the person.
Even if it sounds weird, there are different levels of consciousness. To understand this, an useful scale is the AVPU one (Alert, Verbal, Pain, Unresponsive). “Alert” is when the patient has open eyes and can answer simple questions (“What happened”/”What’s your name?”).
“Verbal” level is given to a person who is confused or sleepy but can react to verbal stimuli. However, once those are gone, the previous state is restored.
“Pain” level instead is when the patient only reacts to pain stimuli (rubbing the hand on the chest, but it’s not the only way).
When the brain’s shutting down the first thing we lose is alertness, then the reaction to verbal stimuli and finally to pain stimuli.
As you can imagine, if a patient responds to the pain stimuli only means his condition is much worse than one that’s alert or that responds to verbal stimuli.
This is the only way we rub the chest. It’s not a resolutive maneuver. I guess it’s like throwing a bucket of ice cold water on someone’s face while they’re asleep. If they’re really tired, they won’t even notice. If however they’re less tired, they’ll complain and go back to sleep.
Fyi, to treat an overdose, usually other drugs are used (for opioids, Naloxone is used). These fight the other drug and the patient turns vigile and alert almost immediately
Please excuse any grammar mistakes, hope to have been clear enough 🙂
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