LonghornMedic
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Fentanyl is overrated in my opinion. I wish we had it back.
What pain management options do you have?
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Fentanyl is overrated in my opinion. I wish we had it back.
LonghornMedic
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I should clarify...I wish we had morphine back.
Updated to include what?
jjesusfreak01
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Chest tubes
the final decision is up in the air still, but apperently there to include ibprofen mainly because we deal with alot of soft tissue injuries
slb862
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Fentanyl
Morphine
Versed
Ativan
Toradol
Lidocaine
Zofran
Nubain
Let's not forget the good ole O2.
I prefer Fentanyl anyday, along with bump of Morphine, then add a little Versed. Yummy, and then don't forget the Zofran when the Morphine makes them wanna puke.
Morphine
Versed
Ativan
Toradol
Lidocaine
Zofran
Nubain
Let's not forget the good ole O2.
I prefer Fentanyl anyday, along with bump of Morphine, then add a little Versed. Yummy, and then don't forget the Zofran when the Morphine makes them wanna puke.
I'm fairly certain, that despite the lies told everyday in EMT classes nationwide, O2 has no analgesic properties...
reaper
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No, but O2 works in different ways, which can reduce pain. Headache treatments is one good example. High flow O2 is one of the best treatments available. So never under estimate the little power of O2! Haha
O2 has been definitively shown to be effective for pain only in the setting of cluster headache, by an unknown mechanism. I've never come across anything else claiming analgesic properties besides a few misguided EMS instructors. So never overestimate O2 either
h34r:.
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reaper
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O2 has been definitively shown to be effective for pain only in the setting of cluster headache, by an unknown mechanism. I've never come across anything else claiming analgesic properties besides a few misguided EMS instructors. So never overestimate O2 either
Point exactly! We cannot overestimate O2, because we do not fully understand the function it provides on the body
It's use has been well documented in Cluster headaches. They have no idea why it works, just know that it does. Until we completely understand how it works on different receptors, we cannot say that it has no analgesic effects!
Point exactly! We cannot overestimate O2, because we do not fully understand the function it provides on the body
It's use has been well documented in Cluster headaches. They have no idea why it works, just know that it does. Until we completely understand how it works on different receptors, we cannot say that it has no analgesic effects!
Pain in general is not a well understood reaction. We have however, managed to isolate most of the neurons and receptor systems responsible for pain and analgesia. Thing is, oxygen reacts with none of them. The only receptors O2 (notice O2, there are oxide neurotransmitters) interacts with regularly are chemo and baroreceptors. So O2, by it's self, does not provide analgesia. O2 won't make a broken femur feel better, narcotics will. Cluster headaches are the proving exception.
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swissmedic
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Hello everyone
I am 34 year old senior medic, I am working in hospital based system in SWITZERLAND.
We have no special pain management protocols,
We normally use morphine for any CHF patient, for any trauma patient we use fentanyle ( I really like this meds) or we use ketamine and dormicum (versed) and for pediatric we use nalbuphin, fentanyl or ketamine. So you have the choise, the right drug for every special situation...
We use iv, im, sc and io for any drug application
Matt
I am 34 year old senior medic, I am working in hospital based system in SWITZERLAND.
We have no special pain management protocols,
We normally use morphine for any CHF patient, for any trauma patient we use fentanyle ( I really like this meds) or we use ketamine and dormicum (versed) and for pediatric we use nalbuphin, fentanyl or ketamine. So you have the choise, the right drug for every special situation...
We use iv, im, sc and io for any drug application
Matt
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slb862
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Let's not forget: Treat the patient. I have used O2 as a calming "drug". AND if the pt. finds it calming I find it easier to interact, enabling me to give appropriate pain medications.
Besides, if there was no O2 then we would all be screaming. :blink:
Besides, if there was no O2 then we would all be screaming. :blink:
Any evidence to back up use of O2 as an anxiolytic? Aren't there much more effective drugs for this purpose? How much have you learned about theraputic communication?
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waltcallie
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I'm guessing that you guys don't hire 12 week Parathinktheyare's and Medicfighters from the Paramedic patch factory for the barely homeostasasing if you use all those meds
Just remember "Mr. Brown", there is always someone faster, smarter, stronger, and better looking than you. Everyone was a newbie at one point or another and the ones who succeed are the ones who lose the attitude, remain humble, and let their skills do the talking.
We're not out to take your job, you don't have to impress us! :beerchug:
18G
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I think slb862 was referring to the psychological or placebo effect of giving someone a treatment (ie oxygen). The patient only think's that it is helping and in turn the patient calms themselves down. He wasn't insinuating oxygen has anxiolytic properties (least it didn't sound like it to me).
However, this could be argued on a secondary basis. A hypoxic patient can be extremely anxious, you give them oxygen to correct the hypoxia, and in return they breathe better and have less anxiety hence an indirect anxiolytic property.
However, this could be argued on a secondary basis. A hypoxic patient can be extremely anxious, you give them oxygen to correct the hypoxia, and in return they breathe better and have less anxiety hence an indirect anxiolytic property.
pain management.....?
Well, let me see.
If you are very brave you can give a pt ketorolac.
I say if you are brave, because when you arrive to the hospital the physician is gonna eat you alive.
And that´s it.
Few ambulance services in Mexico City carry and use strong analgesics. No morphine for the mexican people because it is a very VERY controlled drug.
I envy you (and my patients who scream at every pothole we hit in the street also do).
Well, let me see.
If you are very brave you can give a pt ketorolac.
I say if you are brave, because when you arrive to the hospital the physician is gonna eat you alive.
And that´s it.
Few ambulance services in Mexico City carry and use strong analgesics. No morphine for the mexican people because it is a very VERY controlled drug.
I envy you (and my patients who scream at every pothole we hit in the street also do).
Melbourne MICA
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Collateral Damage
A truly unique and unenviable situation. Yet another example of the widespread effects on the community (yours in this case) of the activities of the drug cartels.
Mexican Paramedics are to be admired for their courage and sense of community. There are at least some people left in the world who have a moral imperative about public service and the good of all.
Money, money, money.
Capitalism sucks big time as far as I'm concerned. There's no future for societies vested entirely in self interest alone. There's no better example than the drug trade for both capitalism at work and the notion of pre-eminent self interest.
MM
A truly unique and unenviable situation. Yet another example of the widespread effects on the community (yours in this case) of the activities of the drug cartels.
Mexican Paramedics are to be admired for their courage and sense of community. There are at least some people left in the world who have a moral imperative about public service and the good of all.
Money, money, money.
Capitalism sucks big time as far as I'm concerned. There's no future for societies vested entirely in self interest alone. There's no better example than the drug trade for both capitalism at work and the notion of pre-eminent self interest.
MM
Our only medication option is IV/IN/IM fentanyl. Morphine was taken away about 2 years ago. Midazolam and diazepam were under a "pain/anxiety" management guideline but with our latest clinical guideline revision they are no longer approved for that use (which is unfortunate).