paramedicmike Posted November 12, 2013 Share Posted November 12, 2013 Got this through work. I thought it was interesting. For those of you based in the US it might be good info to know. Click me. Link to comment Share on other sites More sharing options...
ERDoc Posted November 12, 2013 Share Posted November 12, 2013 But but but, they have 20 out of 10 pain. You are not them and cannot judge if they are really in pain!!! I could not believe the amounts of narcotics prescribed when I moved here to MI. We were told by the police that of all of the prescription narcotics they confiscate, they can trace about 70-80% back to our ERs. I am pretty stingy when it comes to narcs unless there is verified pathology. I've had people see me in the ER and leave without being seen. Link to comment Share on other sites More sharing options...
Kiwiology Posted November 12, 2013 Share Posted November 12, 2013 Damn Emergentologist you scary! When I lived in US I was amazed at how many average people were on a shopping bag full of meds, and how many of them were on some sort of narcotic; oral morphine, fentanyl patches, percocet, percodan, methadone, you name it ... As an aside I notice in US pain management is pretty poor especially for acute pain in the ED; lots of fentanyl and hydromorphone and not a lot else being used but then again damn US is so big and variance so wide who the hell knows .... Link to comment Share on other sites More sharing options...
paramedicmike Posted November 12, 2013 Author Share Posted November 12, 2013 Personally, I like it when people claim they've never been on prescription narcotics before and I can present them with a list of all their recent medication refills. "Let's see. You got 140 15/325 percocets three days ago. You got 120 8mg dilaudid four days ago. Both of these are refilled on a monthly basis for the past 19 months. What did you do with it all?" Among my most recent was a guy on 60mg morphine ER twice a day along with 8mg dilaudid ER twice a day. He said he was in so much pain he was crying. He was in so much pain that every time I walked into the exam room I had to physically wake him up to talk to him. Link to comment Share on other sites More sharing options...
ERDoc Posted November 12, 2013 Share Posted November 12, 2013 I think we work in the same hospital, Mike. Link to comment Share on other sites More sharing options...
Richard B the EMT Posted November 12, 2013 Share Posted November 12, 2013 Guess I'm lucky. One Aleve, possibly 2 a day, and I'm usually good (Back injuries, both knees giving me issues post torn meniscus corrective surgery). Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted November 12, 2013 Share Posted November 12, 2013 Or the patients who are joking and laughing when you stand outside the room and when you enter they start to writhe on the bed in pain. I even had the doctor stand outside he room of one of them doing it one day for the doctor because he didn't believe me. That patient didnt' get their requested narcotics. And then theres the ones who are allergic to Ketorolac but not allergic to Toradol. Link to comment Share on other sites More sharing options...
MariB Posted November 13, 2013 Share Posted November 13, 2013 My daughter has been given hydro, norco, and percoset like its candy. I finally asked her infectious disease doc who is going to pay for her rehab. She told me people who have pain never get addicted. Here, have a few more oxy Link to comment Share on other sites More sharing options...
ERDoc Posted November 13, 2013 Share Posted November 13, 2013 Don't forget, there is a difference between being dependent and addicted. Link to comment Share on other sites More sharing options...
Kiwiology Posted November 13, 2013 Share Posted November 13, 2013 I like it how the Medical Council here has vocational registration so that, e.g. an infectious diseases physician would be limited in the amount of narcotics he could prescribe and would have to refer the patient to a pain physician (such a speciality doesn't exist but the pain clinic is run by the anaesthetists). Not exactly sure how it works but the general principle with practicing and prescribing within your vocational scope is to prevent a GP from practicing and prescribing that which is the realm of e.g. a specialist psychiatrist or a dermatologist practicing oncology. What's that? Why yes Emergentologist you can exchange your FACEP for a FACEM and yes ... it's summer here and none of that pesky being sued stuff to worry about Link to comment Share on other sites More sharing options...
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