We find our patient by the elevator doors in a public building. He is on all fours, dry heaving, and shaking. He says he is in terrible pain. Security tells us he is a visitor to this public building. They don’t know anything about him other than that he has been screaming that he is…
Category: Pain Managment
These Go to 11
“I don’t think you understand,” my preceptee said. “Zero is no pain, 10 is like an alligator biting your leg off pain.”
EMS Changes
The number one treatment change in EMS in the last twenty years is the increased emphasis on painmanagement and comfort care. Albert Schweitzer said, “Pain is a more terrible lord of mankind than death himself…. We must all die. But that I can save him from days of torture, that is what I feel as…
Pain-Why Call Now?
I used to get upset when the call was for an old fall or fall yesterday or fall last night. The same when I’d get called for abdominal pain and a person says they have been having the pain for two weeks or three months. I got upset because the nature of the call was…
Drug Seeker
So this man is, based on my experience, a drug seeker. This is not a first impression or an instinct. I say this based on seven or eight years of transporting this patient (our service transports the patient anywhere from one to four or five times a month) to multiple hospitals. The calls are not…
The Cat that Didn’t Move
The patient — a forty-year-old man — says his back is killing him. He has sciatica. He is on Oxycodone, but his vial is empty and his doctor won’t give him a refill. I look at the vial. It was filled six days ago. You should still have pills left, I say. “You won’t believe…
Pain Control
My new preceptee is doing great. On most calls I am a complete invisible man, just sitting back and watching her work. If I offer anything, it is usually just a small trick of the trade. Since she is only part-time, we only work together a couple times a week so I am still doing…
A Two Year Old’s Pain
Thirty percent of the calls in my town are patients over 80 years old. Lots of pneumonias, CVAs, COPD, hip fractures, etc. We rarely get kids. Started off the day with a 95-year-old who “went into a trance” and “fell out.” When we got there, there were people running toward the house in panic and…
Tincture of Chicken Soup
I have been a big advocate of pain relief for patients. All the studies show that patients are consistently undermedicated both prehospitally and in the ER. Pain relief is something we can do that makes a huge difference for the patient. We can take care of their pain. I try to be as aggressive as…
Carolina Tall Tale
I’m working on the computer when we get the call. I am in fact in the middle of downloading a program. Bad timing. There is no way I can wait for the download to finish. I decide to just minimize the window amd leave it at that. Only when we are on the way to…
It is Unethical
230 lb guy slips in the shower, lands on his shoulder. When we get there he is in extreme pain and has an obviously deformed shoulder. It is either fractured, dislocated or both. What do you do for pain? Morphine. Okay, now here’s the catch. The location is a drug and alcohol rehab clinic, the…