giving Narcotics like candy

[Dustdevil]

Good points, guys. Two runs from the past stick out in my mind.

I picked up a middle aged male from police custody outside of the burning meth lab that was his home. It blew up as it was being raided, and once he was in custody he began complaining of chest pain and SOB, so we were called. He had a history of prior MI, chest pain unresponsive to nitro, stable VS, and symptoms which strongly suggested another MI. We were 20 minutes from the nearest hospital. I gave MSIV. The doctor who had to wake up in the middle of the night to come to the ER made one of those smart-ass remarks about me wasting MS on somebody with nothing wrong with them. Ten minutes later, after seeing the 12 lead, he personally apologized to me.

Then there was the elderly lady with the broken hip on the bathroom floor in the middle of the night. She was in severe pain and any movement only aggravated it. I called medical control (obviously a different system from the above case) to request MS prior to packaging and transporting the patient. The A-hole doc quickly said, "I don't believe in that. I'm busy. I gotta go." and walked away from the radio. "I don't believe in that?" WTF is that supposed to mean? He didn't even stay online long enough for me to ask if he might be more comfortable with Stadol or Nubain. When we got to the ER, I was sure to point that doctor out to the patient and her family and let them know that HE was the one who didn't "believe in" pain medicine for hip fractures. And I made sure he heard me tell them.

[DFDEMS]

We could not even move her an inch with out her screaming in pain

If your protocol’s say you can for pain management Prehospital then just nod "yes sir.." to the doc and drive on.

Personally, I probably would have given it to her just so she wouldn’t scream in my ear while extracting her...

[EMT001]

Well.... I like candy and I also like narcotics. You don't happen to have any, do you?

[BlackSheep]

Quote:"I gave her 7.5mg IM-protocol is 5-15mg (could not get a line) I did not want to totally snow her."

And for that you were questioned :?:

[LukeWarmwater]

"You will know (the good from the bad) when you are calm, at peace. Passive." A Jedi uses the Force for knowledge and defense, never for attack.

Yoda-

"A Jedi's strength flows from the Force."

Yoda-

[Asysin2leads]

You know, I always see the "abuse in urban settings" hogwash come up in discussions of pain control. First off, junkies do not call 911 to get a shot of morphine. Theymight ROB the ambulance to get the morphine, but they ain't gonna call 911 repeatedly reporting pain and have their habit sustained by EMS crews. Heroin addiction is way to powerful to rely on something that elaborate, as is the addicition to benzodiazipines. There will be many many many more stolen prescription pads and liquor store hold ups even if you relaxed the standards for narcotics administration than phony calls for pain by a heroin addicted person. Secondly, just as an urban dweller, I like to point out LIKE IT OR NOT CRIME, JUNKIES, AND ADDICTION HAPPEN IN MIDDLE AMERICA TOO! What, you think no ones getting high in places with less police presence?

[zippyRN]

You know, I always see the "abuse in urban settings" hogwash come up in discussions of pain control. First off, junkies do not call 911 to get a shot of morphine. Theymight ROB the ambulance to get the morphine, but they ain't gonna call 911 repeatedly reporting pain and have their habit sustained by EMS crews. Heroin addiction is way to powerful to rely on something that elaborate, as is the addicition to benzodiazipines. There will be many many many more stolen prescription pads and liquor store hold ups even if you relaxed the standards for narcotics administration than phony calls for pain by a heroin addicted person. Secondly, just as an urban dweller, I like to point out LIKE IT OR NOT CRIME, JUNKIES, AND ADDICTION HAPPEN IN MIDDLE AMERICA TOO! What, you think no ones getting high in places with less police presence?

so why then were there peope who used to travel around the UK faking renal colic when pethidine was the first line drug ? Heroin addicts won't be seeking drugs from the ED, but some people do attend the ED or get scripts from primary care for opiates and /or benzos.

[Dustdevil]

Junkies seek narcs through complaints of chronic pain. Back spasms. Migraines. They know better than to try and fake acute injuries, as they have found out very fast that it doesn't work if we don't find any signs. And they are pretty easy to pick out too, since they are always "allergic to Stadol and Nubain." That's why they show up at the ER instead of calling an ambulance. Failing to find anything, the doc simply writes them a script to get them out of his ER.

[Asysin2leads]

Yes, it is well known junkies of all shapes and sizes fake chronic pain to feed their habit. But a prescription will last them 30 days, or at least a couple days, depending on how they take it. However, I would really have a hard time believing that a significant amount of opiate addicts would be constantly calling 911 complaining of ACUTE pain (i.e. a broken arm, leg, rib, etc.), which is what EMS would be dealing with. I could see an argument to not allow EMS to use narcotics for chronic conditions for that reason, but use as pain management in acute settings, I really don't think you could say "If we start giving fentanyl to entrapped MVA patients, the junkies are going to start crashing their cars to get the drugs."

[LukeWarmwater]

"Fear is the path to the dark side. Fear leads to anger. Anger leads to hate. Hate leads to suffering."

May the force be with you - Luke WarmWater Jedi Master