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Sat, 12 Apr 2003 02:29:30 +0100

----- Original Message -----
From: "Richard Buck" <teotwawki@sbcglobal.net>
To: <trauma-list@trauma.org>
Sent: Friday, April 11, 2003 5:29 PM
Subject: RE: Opiates & the Acute Abdomen

> In my admitted ignorance, I'm puzzled as to why Narcan can't be used to
> temporarily negate the effects of narcotic analgesics for the brief period
> when a surgeon needs to have the patient's true pain level present to
> accurately assess an abdominal injury.

is a 'true' pain level needed ?

all that is needed is the patient to  be fully alert and aware and not to
have been anaesthetised by excesive medication- if pain is well controlled
at rest , the rpessure used to elict response in examining the paitnet will
eleict a response - anyway  how does the patient's pain levle make a
difference to your management of the patient ?

> Isn't that win/win for patients

no it isn't it's playing to the surgicla temperement, i am sure my senior
colleagues both nursing and medicla would support the sentiment hat the
surgeons can do what they lie when they have taken the responsibilirty for
the paitnet but while their are under the care of the ED - pain management
will be addressed as the ED staff see fit .

> who are in pain and must wait for attention (perhaps for hours) yet can
> present s/s faithfully to the diagnosing physician during the assessment
> (perhaps minutes)?

sadequate and approrpaite analgesia will not mak signs or symptoms, if signs
or symptoms are maksed to suvch and extent  i think most people would agree
that the patient hads been over medicated

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