Sternum Rub on conscious, responsive patient with fractured ribs to test motor/sensory function
I’m supporting my cousin (40F) who is in the trauma unit of a hospital right now because of a head on car crash where she was sitting in the middle rear seat between two carseats. She has fractured ribs (4-11 on the right and 8-11 on the left). Most of her organs are damaged, including bruising on her heart, laceration on liver, bilateral lung pneumothorax, brain bleed, fractured L1-L2, complete spinal cord injury, spinal cord severed at T5. Her spleen had to be removed and she has a broken arm. And recently, a contusion at T8. She is intubated and has many chest tubes.
This morning during a neuro check she was responding to questions from the nurse by blinking hard twice, and was more alert than the last two days. However, where she had been able to move her fingers and arms on the first day, she was not able to do so this morning. After pinching her arm did not get her to move her hand, the nurse performed what I now know is a sternum rub, pushing down fairly hard. She was in excruciating pain, in that her eyes bugged out, she tried to scream, and lifted her head off the pillow. The nurse repeated the procedure and told her to swat away his hand. She had the same pain response and never moved her arm or hand.
I didn’t know when he performed this test about her fractured ribs, but after learning, I called and spoke to the charge nurse. She said it was all standard procedure.
I understand the need to assess neurological conditions, but this method seemed unnecessarily cruel and possibly damaging.
Is this in fact standard practice in the US? If so, I’ll rest easy and just try to help her through it the next time.
If not, what else can I say to her care team to get them to use alternate methods that would cause less harm?
Thanks all for your help.