Morphine Often Underdosed in Emergency Medicine

[nsmedic393]

One more thing;

For those of you who try to judge for yourself how much pain the patient is having despite what they tell you (you think they are faking, an addict or their pain isn't really that bad) I ask you this

Would you have the balls to withhold treatment from a patient having chest pain because you didn't think he was really having bad pain or because you thought he was trying to get MS for an addiction? Didn't think so...

The patient told you he was having pain, weather its chest pain or finger pain who are you to decide otherwise.

[aussie_rn]

exactly, a person's pain is what they say its is, regardless of what we think! We had a lady come in one day, a known drug seeker, in extreme pain, despite what we thought we gave her the pain relief!

[medik8]

I'm pretty aggressive....I say...you hurt? I'm your Dr. Feelgood. lmao. I get a kick out of seeing their eyes roll around and their mouths go....MSedklfjasd;lkjfwepoijfalkdjfadkl;jf.... That's good stuff....right there...

On a serious note though...if the patient is having pain, I say go for it.

BTW...(I've had about 10 glasses of wine as I write this to dull my own pain....so.....forgive me if this makes no sense. LMAO! :shock:

xoxoxo

*8*

[JakeEMTP]

....MSedklfjasd;lkjfwepoijfalkdjfadkl;jf.... .

BTW...(I've had about 10 glasses of wine as I write this to dull my own pain....so.....forgive me if this makes no sense. LMAO! :shock:

xoxoxo

*8*

I understood the first part 8! I've had about that many brown pops, so I guess I should understand it!!!! LMFAO

[medik8]

Jake.....I knew you would understand me, even if no one else did. LMAO. *XOXOXO* :wink:

I don't get the "conservative" narcotic approach....if you have the ability to make the pain go bye bye (provided there are no reasons not to...).....then let's get on it....what are we waiting for? :roll:

[kevkei]

One more thing;

For those of you who try to judge for yourself how much pain the patient is having despite what they tell you (you think they are faking, an addict or their pain isn't really that bad) I ask you this

Would you have the balls to withhold treatment from a patient having chest pain because you didn't think he was really having bad pain or because you thought he was trying to get MS for an addiction? Didn't think so...

The patient told you he was having pain, weather its chest pain or finger pain who are you to decide otherwise.

So if a patient tells you they have 'chest pain' do you treat with ASA, Nitro, MS, just because they had chest pain or do you perform a differential and come up with a working diagnosis, regardless of the fact it appears it is non cardiac?

I have and will continue to with hold analgesics from some patients. I think it is poor judgement to flat out give all who have 'pain', pain control. There are patients where their history, presentation and signs and symptoms don't match what they claim. Now granted, they are few and far between but it does happen and we have all seen them.

[nsmedic393]

Hey Kev

Didn't say anything about differential diagnosis. If you think their is a different cause for the CP than go ahead and treat that with whatever you need to. Whatever the underlying cause you should still do everything you can to make your patient more comfortable. Weather your treatment is MS, NTG, splinting, O2, pillows or talking the patient down, its a pretty rare day that a patient tells you they are having pain and you can look them in the eye and say "no you are not".

[hammerpcp]

[quote="aussie_rn

Here we have a "pain protocol" towards giving morphine where it is titrated until the patient's pain is under control, I've given up to 60mg (over several hrs) of morphine to a patient with pancreatitis, and surprisingly the patient was still able to walk around (much to my dislike) and not have have any other side effects from the high dosage!

[hammerpcp]

exactly, a person's pain is what they say its is, regardless of what we think! We had a lady come in one day, a known drug seeker, in extreme pain, despite what we thought we gave her the pain relief!

The boy who cried wolf anyone?

Anyway, if she is drug seeking you really aren't doing her any favours by enabling that addiction. It is the hospitals/ems workers responsibility to control controlled substances.

[nsmedic393]

Does an addict ever have pain? Its not our job to manage their addiction. Its our job to take care of their presenting problem. Can you tell if they have pancreatitis or not? Apendicitis? Back Pain? Diverticulitis?

I think its far more negligent to withhold pain meds because you THINK the patient is seeking drugs than it is to give drugs to a junkie.