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Sat, 12 Apr 2003 08:38:40 -0500

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I have no problem with medics making decisions, they make sound ones =
everyday.  I have a problem with medics who break protocol (just like I =
have a problem with nurses who break protocol).  The problem I describe =
is a multisystem trauma patient with borderline vitals who gets 10mg of =
MS IV.

Then when they hit the ER, are they altered because of the MS or brain =
injury?  Are they hypotensive because of the MS or bleeding?

Medics do great job, but they should not be practicing medicine, if they =
feel a patient would benefit from an intervention that is not covered by =
their protocol then that is why they have radios and cell phones, to =
call in and discuss/request from the ED physician getting the patient.

Andrew
  ----- Original Message -----=20
  From: michael riordan=20
  To: trauma-list@trauma.org=20
  Sent: Saturday, April 12, 2003 1:32 AM
  Subject: pain and suffering

  Andrew,

   I seem to recall you posted a like thread like this before. You seem =
to have a problem with paramedics making a decision. Do you think every =
trauma patient in the field will become hypotensive after morphine is =
given? Or is it that it only happens with paramedics?=20

  Luckily in Australia we dont have such regressive thinking. IC paras =
dont need to consult. We would more likely get strange looks at the ED =
if we took a patient into hospital in pain (from whatever) that should =
have been reduced. =20

  What is wrong with giving morphine to a patient in pain? Especially =
from trauma. Especially in outlying areas. You would prefer some one to =
be in pain until the hospital? I cannot fathom the logic.=20

  Michael

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<BODY bgColor=3D#ffffff>
<DIV><STRONG><FONT face=3DTahoma size=3D2>I have no problem with medics =
making=20
decisions, they make sound ones everyday.&nbsp; I have a problem with =
medics who=20
break protocol (just like I have a problem with nurses who break=20
protocol).&nbsp; The problem I describe is a multisystem trauma patient =
with=20
borderline vitals who gets 10mg of MS IV.</FONT></STRONG></DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2></FONT></STRONG>&nbsp;</DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2>Then when they hit the ER, are =
they=20
altered because of the MS or brain injury?&nbsp; Are they hypotensive =
because of=20
the MS or bleeding?</FONT></STRONG></DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2></FONT></STRONG>&nbsp;</DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2>Medics do great job, but they =
should not=20
be practicing medicine, if they feel a patient would benefit from an=20
intervention that is not covered by their protocol then that is why they =
have=20
radios and cell phones, to call in and discuss/request from the ED =
physician=20
getting the patient.</FONT></STRONG></DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2></FONT></STRONG>&nbsp;</DIV>
<DIV><STRONG><FONT face=3DTahoma size=3D2>Andrew</FONT></STRONG></DIV>
<BLOCKQUOTE dir=3Dltr=20
style=3D"PADDING-RIGHT: 0px; PADDING-LEFT: 5px; MARGIN-LEFT: 5px; =
BORDER-LEFT: #000000 2px solid; MARGIN-RIGHT: 0px">
  <DIV style=3D"FONT: 10pt arial">----- Original Message ----- </DIV>
  <DIV=20
  style=3D"BACKGROUND: #e4e4e4; FONT: 10pt arial; font-color: =
black"><B>From:</B>=20
  <A title=3Driordanms@optusnet.com.au=20
  href=3D"mailto:riordanms@optusnet.com.au">michael riordan</A> </DIV>
  <DIV style=3D"FONT: 10pt arial"><B>To:</B> <A =
title=3Dtrauma-list@trauma.org=20
  href=3D"mailto:trauma-list@trauma.org">trauma-list@trauma.org</A> =
</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Sent:</B> Saturday, April 12, 2003 =
1:32=20
  AM</DIV>
  <DIV style=3D"FONT: 10pt arial"><B>Subject:</B> pain and =
suffering</DIV>
  <DIV><BR></DIV>
  <DIV><FONT face=3DArial size=3D2>Andrew,</FONT></DIV>
  <DIV>&nbsp;</DIV>
  <DIV><FONT face=3DArial size=3D2>&nbsp;I seem to recall =
you&nbsp;posted a like=20
  thread like this before. You seem to have a problem with paramedics =
making a=20
  decision.&nbsp;Do you&nbsp;think every trauma patient in the field =
will become=20
  hypotensive after morphine is given? Or is it that it only happens =
with=20
  paramedics? </FONT></DIV>
  <DIV><FONT face=3DArial size=3D2></FONT>&nbsp;</DIV>
  <DIV><FONT face=3DArial size=3D2>Luckily in Australia we dont have =
such regressive=20
  thinking. IC paras dont need to consult. We would more likely get =
strange=20
  looks at the ED if we took a patient into hospital in pain (from =
whatever)=20
  that should have been reduced.&nbsp; </FONT></DIV>
  <DIV>&nbsp;</DIV>
  <DIV><FONT face=3DArial size=3D2>What is wrong with giving morphine to =
a patient=20
  in pain? Especially from trauma. Especially in outlying areas. You =
would=20
  prefer some one to be in pain until the hospital? I cannot fathom the =
logic.=20
  </FONT></DIV>
  <DIV>&nbsp;</DIV>
  <DIV><FONT face=3DArial =
size=3D2>Michael</FONT></DIV></BLOCKQUOTE></BODY></HTML>

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