Pain relief and EMS

[tniuqs]

"chbare"]Diclofenac and Tramadol administered via parenteral routes are drugs of the year over here. I agree that Toradol has great properties; however, the side effect and caution profile for this med is substantial. Like most NSAID's GI complications are going to be a concern and the effects on the renal system must also be considered.

Yes thats why I was considering dumping Toradol, GI PMHX maybe when it expires but the old boys say its the way to go with renal colic, btw Diclofenac is killing the worlds vultures .... hmmm ?

I would not be a big advocate of using Pontocaine in the field. The safety profile does not justify using it IMHO. Especially due to the fact that our ability to treat and recognize ophthalmic conditions is quite limited.

I get a lot of wood chips with the chainsaw gangs , Pontocaine great for one or 2 doses to inspect, makes life easier all the way around, yes it can if used excessivly delay healing for arc flash conjuntivitis, funny it was OTC here until just lately .... damn welders ! Morgan lenses and a Marcaine drip the best for longer term relief, saves the opiates, and chopper time.

Taking care is my job .

[rock_shoes]

As a PCP, we use Entonox for pain relief. As Mike mentioned it is disappointing how few PCPs use Entonox for pain control; I use it and find it very effective.

There is talk of giving PCPs in BC a morphine protocol for long distance transfers because trying to administer Entonox for 4+ hours is unrealistic.

We better include gravol for PCP's as well if they include morphine. I've had mixed success with entonox so far working in BC. It's very effective with many patients and useless with others. If I remember correctly Tramadol was also up for evaluation as an add to the PCP scope in BC.

[crotchitymedic1986]

Last service I worked for had a fairly good selection, and a protocol as to when narcs could be administered. If I remember right, we had Motrin, Tylenol, Toradol, Imitrex, Mepergan, Valium, Versed, and Morphine.

They had Inapsine for chemical restraint, but went to Haldol when Inapsine was recalled.

Not sure what they have now.

[medic112]

We have Morphine / Fentanyl.

Versed

Valium.

Wish we had Nitrous Oxide. but oh well. its on the approved drug list for the state.

[mrmeaner]

As for splinting etc as a method of "pain relief"' date=' while i'll admit that it does reduce pain, actually performing the procedure as a method of obtaining relief without giving meds for the purpose of splinting is just barbaric. Are there any people here who feel it is exceptable to splint / apply traction without meds (if they are available)/quote']

I intended to follow up on my earlier post, but forgot about this thread.

I do use medications for pain management, but I'll start with the basics first. Not because I have a "BLS before ALS!" shirt at home, but I have found plenty of patients who would rather avoid meds. Also, some patients do enjoy somewhat of a medication holiday as they are tired of feeling disconnected from the world, especially the ones who are terminal cancer patients.

If a patient needs chemical pain control, they will receive it. But the patient is commonly involved in thbe decision. Hope his clears up my post a little.

[BushyFromOz]

I intended to follow up on my earlier post, but forgot about this thread.

I do use medications for pain management, but I'll start with the basics first. Not because I have a "BLS before ALS!" shirt at home, but I have found plenty of patients who would rather avoid meds. Also, some patients do enjoy somewhat of a medication holiday as they are tired of feeling disconnected from the world, especially the ones who are terminal cancer patients.

If a patient needs chemical pain control, they will receive it. But the patient is commonly involved in thbe decision. Hope his clears up my post a little.

you post is fine mate, i hope i didn't offend you, deffinately not my entention. It just popped in my head as a side note. Im sure there are a few here who honestly think its ok to traction out a midshaft femur to provide pain releif without seeing if those who can provide it chemically are available.

[mrmeaner]

I agree. Regardless of your level, you need to use all the tools you have available.

[firedoc5]

I agree. Regardless of your level, you need to use all the tools you have available.

That's what I've always said. What's the use of having them and being trained to ustilize them if you're not going to use them?

[CTXMEDIC]

you post is fine mate, i hope i didn't offend you, deffinately not my entention. It just popped in my head as a side note. Im sure there are a few here who honestly think its ok to traction out a midshaft femur to provide pain releif without seeing if those who can provide it chemically are available.

even if i have analgesics available (which i do), im still going to stabilize a femur fx.

[BushyFromOz]

even if i have analgesics available (which i do), im still going to stabilize a femur fx.

Oh yeah, imot saying give meds and dont traction. Im saying i hope theres no one here who would tration them out and then decide they need chemical relief. I know its not on some skill sets but at least try to find someone who could provide it.