Rogue feels your pain

Rogue Medic, the interwebs machine’s expert on scientific study as it relates to us EMS folken, has published a great article about pain management.  I want you to read it, then take a break and absorb what he has told you.

Then come back here to HMHQ in the coming days when I will expand on some of the themes he mentions.

We in the pre-hospital arena often shy away from dosing folks to the needed point because we’ve been fed lines from the powers that be that we are incapable of accurately assessing, treating and monitoring patients in need of pain medication.

READ THIS ARTICLE and let it sink in.  This will be on the exam.  Check back often for my comments.

Agree? Disagree? Have something to add? Why not leave a comment or subscribe to the RSS feed to have future articles delivered to your feed reader?

6 thoughts on “Rogue feels your pain”

  1. since this is a fairly important topic, i’m just going to paste what i posted over at rogue’s site. forgive me.

    i’d like to add a few thoughts, and please feel free to comment on them.

    1. i have a suspicion that pts who rate their pain 7-8/10 tend to be more honest about their pain than the ones who rate their pain 10/10 (worst pain ever), which perhaps partially explains the study’s findings when sorted by initial pain rating.

    2. competence is a huge factor is any setting, not just ems. there are plenty of (supposedly better-trained) docs and nurses who are clearly retarded.

    3. i personally have a high threshold for when i break the narcs open, as i too work in a poor area. that’s not to say poor people can’t have pain; that’s just taking into account other factors such as a seemingly higher rate of drug use/abuse. (there was also a study about how redheads are less tolerant of pain, so there just might be differences across the races.)

    4. once i make the decision to use narcs, i am not stingy with them as experience shows that prehospital morphine doses are clearly inadequate. the more important issue here is a training crews for a heightened awareness of the potential for respiratory depression and allergic reactions (just had one last week).

    5. it’s a big training issue to get crews to recognize those pts who are in pain and those who are trying to score narcs. this is where experience counts and it’s difficult to teach. that being said, it’s risky to presume that people are trying to score narcs.

  2. since this is a fairly important topic, i’m just going to paste what i posted over at rogue’s site. forgive me.

    i’d like to add a few thoughts, and please feel free to comment on them.

    1. i have a suspicion that pts who rate their pain 7-8/10 tend to be more honest about their pain than the ones who rate their pain 10/10 (worst pain ever), which perhaps partially explains the study’s findings when sorted by initial pain rating.

    2. competence is a huge factor is any setting, not just ems. there are plenty of (supposedly better-trained) docs and nurses who are clearly retarded.

    3. i personally have a high threshold for when i break the narcs open, as i too work in a poor area. that’s not to say poor people can’t have pain; that’s just taking into account other factors such as a seemingly higher rate of drug use/abuse. (there was also a study about how redheads are less tolerant of pain, so there just might be differences across the races.)

    4. once i make the decision to use narcs, i am not stingy with them as experience shows that prehospital morphine doses are clearly inadequate. the more important issue here is a training crews for a heightened awareness of the potential for respiratory depression and allergic reactions (just had one last week).

    5. it’s a big training issue to get crews to recognize those pts who are in pain and those who are trying to score narcs. this is where experience counts and it’s difficult to teach. that being said, it’s risky to presume that people are trying to score narcs.

  3. since this is a fairly important topic, i'm just going to paste what i posted over at rogue's site. forgive me.

    i'd like to add a few thoughts, and please feel free to comment on them.

    1. i have a suspicion that pts who rate their pain 7-8/10 tend to be more honest about their pain than the ones who rate their pain 10/10 (worst pain ever), which perhaps partially explains the study's findings when sorted by initial pain rating.

    2. competence is a huge factor is any setting, not just ems. there are plenty of (supposedly better-trained) docs and nurses who are clearly retarded.

    3. i personally have a high threshold for when i break the narcs open, as i too work in a poor area. that's not to say poor people can't have pain; that's just taking into account other factors such as a seemingly higher rate of drug use/abuse. (there was also a study about how redheads are less tolerant of pain, so there just might be differences across the races.)

    4. once i make the decision to use narcs, i am not stingy with them as experience shows that prehospital morphine doses are clearly inadequate. the more important issue here is a training crews for a heightened awareness of the potential for respiratory depression and allergic reactions (just had one last week).

    5. it's a big training issue to get crews to recognize those pts who are in pain and those who are trying to score narcs. this is where experience counts and it's difficult to teach. that being said, it's risky to presume that people are trying to score narcs.

  4. since this is a fairly important topic, i'm just going to paste what i posted over at rogue's site. forgive me.

    i'd like to add a few thoughts, and please feel free to comment on them.

    1. i have a suspicion that pts who rate their pain 7-8/10 tend to be more honest about their pain than the ones who rate their pain 10/10 (worst pain ever), which perhaps partially explains the study's findings when sorted by initial pain rating.

    2. competence is a huge factor is any setting, not just ems. there are plenty of (supposedly better-trained) docs and nurses who are clearly retarded.

    3. i personally have a high threshold for when i break the narcs open, as i too work in a poor area. that's not to say poor people can't have pain; that's just taking into account other factors such as a seemingly higher rate of drug use/abuse. (there was also a study about how redheads are less tolerant of pain, so there just might be differences across the races.)

    4. once i make the decision to use narcs, i am not stingy with them as experience shows that prehospital morphine doses are clearly inadequate. the more important issue here is a training crews for a heightened awareness of the potential for respiratory depression and allergic reactions (just had one last week).

    5. it's a big training issue to get crews to recognize those pts who are in pain and those who are trying to score narcs. this is where experience counts and it's difficult to teach. that being said, it's risky to presume that people are trying to score narcs.

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