Login
Site Search
Trauma-List Subscription

Subscribe

Would you like to receive list emails batched into one daily digest?
No Yes
Modify Your Subscription

Modify

Home > List Archives

Opiates & the Acute Abdomen

trauma-list@trauma.org trauma-list@trauma.org
Sun, 13 Apr 2003 13:04:25 EDT


--part1_184.19615f37.2bcaf299_boundary
Content-Type: text/plain; charset="US-ASCII"
Content-Transfer-Encoding: 7bit

Have any of us (or you) writing about opiates and acute abdominal pain ever 
had abdominal or chest pain and presented as an emergency to a physician?   

I would suggest that the withholding of pain medicine to a patient who is in 
severe pain is bordering on being coercive.   Adding a bit of tongue in cheek 
logic, some on this web site are using CT (not history or physical 
examination) to evaluate RLQ pain thought to be appendicitis.  If this is the 
direction the world has gone, then use of opiates, sedatives, anesthetics, 
etc. do not matter, for it is not important what is found on the examination 
as decisions are based on the CT.  

Pain control is still poorly understood by those controlling the pain.   I 
found in my own case that the chart of the funny faces was completely 
worthless and when I told the questioner that on a scale of 1-10 my pain 
level was 18 (and it was), he charted that my response was a 7 (wrong).   I 
also found that the dosing for prn pain (except for the PCA pump) was 
entirely subjective and determined by the philosophies and mind set of 
individual nurses and anesthesiologists.  From shift to shift they varied all 
over the map. 

k

--part1_184.19615f37.2bcaf299_boundary
Content-Type: text/html; charset="US-ASCII"
Content-Transfer-Encoding: quoted-printable

<HTML><FONT FACE=3Darial,helvetica><FONT  SIZE=3D2 FAMILY=3D"SANSSERIF" FACE=
=3D"Arial" LANG=3D"0">Have any of us (or you) writing about opiates and acut=
e abdominal pain ever had abdominal or chest pain and presented as an emerge=
ncy to a physician?&nbsp;&nbsp; <BR>
<BR>
I would suggest that the withholding of pain medicine to a patient who is in=
 severe pain is bordering on being coercive.&nbsp;&nbsp; Adding a bit of ton=
gue in cheek logic, some on this web site are using CT (not history or physi=
cal examination) to evaluate RLQ pain thought to be appendicitis.&nbsp; If t=
his is the direction the world has gone, then use of opiates, sedatives, ane=
sthetics, etc. do not matter, for it is not important what is found on the e=
xamination as decisions are based on the CT.&nbsp; <BR>
<BR>
Pain control is still poorly understood by those controlling the pain.&nbsp;=
&nbsp; I found in my own case that the chart of the funny faces was complete=
ly worthless and when I told the questioner that on a scale of 1-10 my pain=20=
level was 18 (and it was), he charted that my response was a 7 (wrong).&nbsp=
;&nbsp; I also found that the dosing for prn pain (except for the PCA pump)=20=
was entirely subjective and determined by the philosophies and mind set of i=
ndividual nurses and anesthesiologists.&nbsp; From shift to shift they varie=
d all over the map. <BR>
<BR>
k</FONT></HTML>

--part1_184.19615f37.2bcaf299_boundary--