Quote from scribblerrn
I say, if a nipple twist is OK, why not a kick to the groin? That would definately illicit a resonse to check for LOC!
Ummm.. I am tempted to just leave it at that!!!
But, I am a lactation consultant so I'll just chime in by saying that first of all I had never even heard of this! I looked it up in my general assessment text which states, "If your patient does not respond to tactile stimuli, you will have to resort to painful stimuli. There are acceptable and unacceptable ways to elicit a response to pain. Never perform a nipple twist!
" ... "Also remember to rotate sites - repeated stimulation at the same site may cause bruising."
The sites that my book lists are:
...for central stimuli:
trapezius squeeze, sternal rub, supraorbital pressure, mandibular pressure
...for peripheral stimuli:
nail pressure, achilles tendon squeeze
Another assessment book I have states "Painful stimuli are used when necessary to obtain eye opening and motor responses. Begin with less painful stimuli such as pinching the skin and progress to squeezing muscle mass or tendons if there is no response."
I think common sense would dictate to use an area of skin/muscle/bone/fat tissue when possible rather than glandular/ductal/organ tissue, just to be on the safe side.
Links to my books for reference:
Nursing Health Assessment: A critical thinking, case studies approach
Mosby's Guide to Physical Examination
(4th edition by Seidel, Ball, Dains, Benedict)
There is a little bit here
about nipple vasospasm secondary to trauma within this write up on nipple blanching and vasospasm in breastfeeding, with references at the bottom of the page. When LC's talk about nipple trauma it is usually as it relates to damage from poor latch/suck by a baby but it can also certainly be from breast surgery or other causes of breast trauma.