Sternal rub, a method once commonly used to assess a patient’s level of consciousness, involves applying firm pressure to the sternum, typically with knuckles. The goal is to elicit a pain response, indicating some degree of neurological function. However, this practice has largely been superseded by alternative methods due to concerns about its potential for harm and questions regarding its reliability.
The primary reason for its decline in favor centers on the potential for causing significant pain and even physical injury. The application of pressure to the sternum can result in bruising, rib fractures, or even soft tissue damage, particularly in vulnerable populations such as the elderly or those with underlying bone conditions. Moreover, some evidence suggests the pain response may not accurately reflect true neurological status, as it can be influenced by factors unrelated to consciousness, such as medication or pre-existing pain conditions. Its historical context stems from a time when fewer refined methods of neurological assessment were available.