How many can give pain meds for abd pain?

[croaker260]

I could repeat or elaborate on what others have said, but instead I will just post an extract of our pain control protocol:

Regarding Abdominal Pain: Narcotic analgesia was historically considered

contraindicated in the prehospital setting for abdominal pain of unknown etiology. It was

thought that analgesia would hinder the ER physician or surgeon's evaluation of

abdominal pain. It is now becoming widely recognized that severe pain actually

confounds physical assessment of the abdomen and that narcotic analgesia rarely

diminishes all of the pain related to the abdominal pathology. It would seem to be both

prudent and humane to "take the edge off of the pain" in this situation with the goal of

reducing, not necessarily eliminating the discomfort. Additionally, in the practice of

modern medicine the exact diagnosis of the etiology of abdominal pain is rarely made on

physical examination. Advancement in technology and availability has made laboratory,

x-ray, ultrasound, CT scan, & occasionally MRI essential in the diagnosis of abdominal

pain. Therefore medication of abdominal pain is both humane and appropriate medical

care.

'Nuff Said

[medicmole]

I know it is more of a BLS treatment but does anyone use nitrous oxide? In our protocols it is a caution with distended abdomen.

[AnthonyM83]

This is a good thing because your pt will not be in pain and you will be able to better assess where they are hurting. To do anything else is cruel and inhumane.

You should come ride out in Los Angeles County, nothing other than a femure fracture will get you morphine...and even then only SOMETIMES, even with stable VS. All non-trauma abd pain with normal vitals, skin signs, and no signs of blood are BLS'ed by the FFMedics where I work.

[ERDoc]

You should come ride out in Los Angeles County, nothing other than a femure fracture will get you morphine...and even then only SOMETIMES, even with stable VS. All non-trauma abd pain with normal vitals, skin signs, and no signs of blood are BLS'ed by the FFMedics where I work.

Only if we get to cruise the beaches.

[AnthonyM83]

Only if we get to cruise the beaches.

Haha, that's half of what we do in the summer in Malibu district (low call volume, low BS volume) and you've got guaranteed celebrity sightings, plus guaranteed motorcyclist down each weekend.

[JPINFV]

I think I need to bring my camera next time I work. Posting at Newport Beach Pier [Hoag Hosp.] is the win.

[sledogg1]

Regarding Abdominal Pain: Narcotic analgesia was historically considered

contraindicated in the prehospital setting for abdominal pain of unknown etiology. It was

thought that analgesia would hinder the ER physician or surgeon's evaluation of

abdominal pain. It is now becoming widely recognized that severe pain actually

confounds physical assessment of the abdomen and that narcotic analgesia rarely

diminishes all of the pain related to the abdominal pathology. It would seem to be both

prudent and humane to "take the edge off of the pain" in this situation with the goal of

reducing, not necessarily eliminating the discomfort. Additionally, in the practice of

modern medicine the exact diagnosis of the etiology of abdominal pain is rarely made on

physical examination. Advancement in technology and availability has made laboratory,

x-ray, ultrasound, CT scan, & occasionally MRI essential in the diagnosis of abdominal

pain. Therefore medication of abdominal pain is both humane and appropriate medical

care.

We can give morphine for Abd pain NYD, lasts 20 mins and it will be back, dx with a ultrasound,ABG's.Don't let your pt's suffer if you have the tools and knowlege to see whats going on............Drs tx these pt's on without pain meds on board and it is wrong on cruel. If you have OLMC call them, explain what u have........CYA.

[Spock]

ERDoc--Your points are well taken but please don't shoot the messenger. Don't forget, I'm in anesthesia and my response to how much opioids can I give is how much do you have! Our chief of surgery feels strongly about this and he is not old school by any means. I think his opinion is a reflection of his lack of respect for our emergency department. Part of this is based on a highly antagonistic relationship between surgery and emergency medicine at our hospital. Perhaps you have a better relationship with your surgeons than we have here. I confess that the relationship between anesthesia and emergency medicine here is not much better. I try to improve this because I know many of the ER docs as a paramedic bringing in patients. They usually chuckle when they see me.

Live long and prosper.

Spock

[Spock]

ERDoc--Your points are well taken but please don't shoot the messenger. Don't forget, I'm in anesthesia and my response to how much opioids can I give is how much do you have! Our chief of surgery feels strongly about this and he is not old school by any means. I think his opinion is a reflection of his lack of respect for our emergency department. Part of this is based on a highly antagonistic relationship between surgery and emergency medicine at our hospital. Perhaps you have a better relationship with your surgeons than we have here. I confess that the relationship between anesthesia and emergency medicine here is not much better. I try to improve this because I know many of the ER docs as a paramedic bringing in patients. They usually chuckle when they see me.

Live long and prosper.

Spock

[ERDoc]

ERDoc--Your points are well taken but please don't shoot the messenger. Don't forget, I'm in anesthesia and my response to how much opioids can I give is how much do you have! Our chief of surgery feels strongly about this and he is not old school by any means. I think his opinion is a reflection of his lack of respect for our emergency department. Part of this is based on a highly antagonistic relationship between surgery and emergency medicine at our hospital. Perhaps you have a better relationship with your surgeons than we have here. I confess that the relationship between anesthesia and emergency medicine here is not much better. I try to improve this because I know many of the ER docs as a paramedic bringing in patients. They usually chuckle when they see me.

Live long and prosper.

Spock

Spock, my comments were in no way directed at you. If there is anything something from anesthesia knows, it's how to make you feel good. That's pretty typical of many surgeons (especially at academic centers). I won't even get into my rant on surgeons and anesthesiologists.