They don't want us bring in abdominal pain patients who are snowed, makes the doctors assessment more difficult.
This is absolutely false.
I don't know who started saying this or when.
The earliest account of witholding pain medication for abdominal pain I can find is from a surgical practice dating back to the early 1900's.
The idea behind it was that because visceral pain is poorly localized, when the peritoneum which does have local stretch receptors becomes inflammed, then the origin of the insult could be deduced.
Unfortunately it wasn't very accurate.
Fortunately, our understaning of pathology and visceral pain mapping has gotten considerably better.
As smash pointed out, controlling abdominal pain actually makes the physical exam easier and more accurate.
I have seen a US trauma surgeon withold pain meds on an abdominal GSW to determine the level of post surgical bleeding was increasing and not properly draining from the tube.
However, considering that the problem could easily be solved by serial ultrasound, I do not advocate repeating that "test."
In defense of the surgeon, because the use of ultrasound is dependant on user skill and not totally objective, its usage in the US is considerably less than in other places. Mostly out of fear of litigation, I am told.
Like any skill, lack of usuage diminishes the skill even further.
The lack of use also equates to lack of training opportunities.
In my book, fear of litigation is not reason enough to leave a patient in pain.
As one of my best preceptors likes to say:
"You would never sue your friend, but would gladly sue your enemy."
I would think making the patient feel better by properly managing pain would make them less likely to sue than more. Even if there were complications to the treatment.
Some people sue no matter what, why worry about it?
