What Is A Sternum Rub?

Are you curious to know what is a sternum rub? You have come to the right place as I am going to tell you everything about a sternum rub in a very simple explanation. Without further discussion let’s begin to know what is a sternum rub?

When it comes to emergency medicine, healthcare professionals often use various techniques to assess a patient’s condition quickly. One such technique is the sternum rub. It may sound unfamiliar to many, but it plays a critical role in evaluating a patient’s level of consciousness and responsiveness, especially in urgent medical situations. In this blog, we will explore what a sternum rub is, how it’s performed, its purpose, and when it’s used in emergency care.

What Is A Sternum Rub?

A sternum rub, also known as a chest rub or sternal rub, is a medical procedure used to stimulate a response in an unconscious or unresponsive person. It involves applying pressure and friction to the person’s sternum, which is the flat bone located in the center of the chest, just below the collarbone. The goal of a sternum rub is to elicit a response from the individual, such as waking them up or observing their reaction to the discomfort.

How Is A Sternum Rub Performed?

Performing a sternum rub requires the following steps:

  1. Preparation: Ensure that the patient is lying on their back and is unresponsive.
  2. Positioning: Stand or kneel at the head of the patient, facing their feet.
  3. Technique: Place your knuckles (usually the knuckles of the middle or index finger) against the patient’s sternum, near the lower part of the breastbone.
  4. Pressure and Friction: Apply firm downward pressure while rubbing the knuckles back and forth across the sternum. The pressure should be enough to cause discomfort but not to inflict injury.
  5. Observation: As you perform the sternum rub, observe the patient for any signs of responsiveness, such as eye movement, grimacing, vocalization, or any other reaction.

Purpose Of A Sternum Rub

The sternum rub serves several crucial purposes in emergency medicine:

  1. Assessing Responsiveness: In emergency situations, it’s essential to quickly determine if an unconscious or unresponsive person is awake and alert or in need of immediate medical attention. The sternum rub helps healthcare providers assess the patient’s level of consciousness.
  2. Prompting a Response: By applying pressure and friction to the sternum, the sternum rub is intended to induce discomfort, encouraging the patient to wake up or react. This response can provide valuable information about the person’s neurological status.
  3. Distinguishing Between Various States: The sternum rub helps differentiate between various states of altered consciousness, such as deep sleep, drug-induced sedation, or a medical condition like a seizure.

When Is A Sternum Rub Used?

A sternum rub is typically employed in emergency situations, especially when a person is unresponsive and there is uncertainty about their condition. It is often used in scenarios such as:

  1. Accidents and Trauma: After accidents or traumatic events, healthcare providers may use a sternum rub to assess the responsiveness of victims.
  2. Overdose: In cases of suspected drug overdose, a sternum rub can help determine if the person is still conscious and potentially intervene with life-saving measures.
  3. Seizures: Following a seizure, a sternum rub can help determine if the individual is returning to a normal state of consciousness.


The sternum rub is a simple yet essential technique in emergency medicine that allows healthcare providers to quickly evaluate a person’s level of consciousness and responsiveness. While it may appear uncomfortable, its purpose is to prompt a response from the individual, providing critical information that can guide appropriate medical intervention in urgent situations. This procedure underscores the importance of timely and effective assessment and care in emergency medical scenarios.

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How Painful Is A Sternal Rub?

Applying pressure straight upward will create severe pain and discomfort. Again, watch the face, hands and arms for any response. It is important to note that the sternal rub, trapezius pinch and supraorbital pressure are all applied to the core of the body.

Is Sternal Rub Recommended?

For instance, the sternal rub may leave bruising (especially on fair skinned patients) and for this reason is discouraged by some. It has been claimed that supraorbital pressure and trapezius squeeze are more effective than the sternal rub or peripheral stimulation, but sternal rub remains the most common.

Why Is Sternal Rub Is Not Recommended To Elicit A Motor Response?

Since the sternal rub does not clearly distinguish between localizing and withdrawal, and it may take up to 30 seconds of firm pressure to the sternum to elicit a response, it may be the least recommended painful stimulus.

Can A Sternum Rub Cause Damage?

Sternal rub is known for bruising in fair-skinned people hence its use has been discouraged. Presternal abrasion is a preventable complication.

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