Do You Feel You Have the Ability To Adequately Control Pain?

[AZCEP]

I find it interesting that you are still using Demerol. Most areas have taken it out of the EMS stockpile out of fear of adverse effects.

What I wouldn't give to have some Toradol as an option.

[JakeEMTP]

What I wouldn't give to have some Toradol as an option.

We do have that option AZCEP. I find it isn't exactly the best pain reliever for the majority of injuries, give it to a pt. with kidney stones and they will love you forever. 8)

[akroeze]

I find it interesting that you are still using Demerol. Most areas have taken it out of the EMS stockpile out of fear of adverse effects.

What I wouldn't give to have some Toradol as an option.

What adverse effects are you referring to that are specific to Demerol?

[AZCEP]

It was reported to have some adverse CNS effects. If I remember correctly, patients were at a greater risk of seizures. Combined with most drug seekers wanting only Demerol.

I know the local receiving hospitals have removed it from their forumularies do to these issues. They've since replaced it with Dilaudid.

[akroeze]

Interesting... do you know if they have moved away from Demerol on your surgical in-patient units? Just curious.

[croaker260]

To be specific, Demerols metabolite, nor-meperidine lowers SZ threshold. In addition, for those patients unfortunate enough to still be on MAOI's, it will have a lethal reaction.

Also, when demerol works, it works well. When it doesn't, it doesn't at all. Not predictable ion my book like Morphine...but thats my experience.

[spenac]

Morphine, Nubain, Toradol, Phenergan, Vistaril, Valium, etc.

[EMS49393]

Morphine, Nubain, Toradol, Phenergan, Vistaril, Valium, etc.

Phenergan is an antiemetic, Vistaril is an antihistamine with anticholinergic properties, and Valium is a benzodiazepine. Although all possess sedative properties, they are not analgesics.

As far as adequate pain control, I feel we don't have adequate pain controls protocols in most EMS systems. I've only worked in one system that had a pain protocol that enabled me to choose from Morphine, Fentanyl, or Demerol for pain control based on what I felt was appropriate for the patient. Patient suffering does not appear to be a high priority with medical directors, and even less of a priority with most paramedics I've worked with.

[scope2776]

Patient suffering does not appear to be a high priority with medical directors, and even less of a priority with most paramedics I've worked with.

Wow... my sentiment exactly....

[spenac]

Phenergan is an antiemetic, Vistaril is an antihistamine with anticholinergic properties, and Valium is a benzodiazepine. Although all possess sedative properties, they are not analgesics.

As far as adequate pain control, I feel we don't have adequate pain controls protocols in most EMS systems. I've only worked in one system that had a pain protocol that enabled me to choose from Morphine, Fentanyl, or Demerol for pain control based on what I felt was appropriate for the patient. Patient suffering does not appear to be a high priority with medical directors, and even less of a priority with most paramedics I've worked with.

Thanks for comment. Should have paid closer attn to question, my bad.

I to see many docs and paramedics fail to give enough for relief. I also have seen medics because our protocols allow to titrate for pain relief stay on seen of broken leg forever it seems while titrating to pain relief rather than packaging and continuing pain management enroute to hospital. We don't get many seekers thankfully. Guess thats more of a big city problem or maybe it's just so easy to go across the border and get what you want. Heck torodol at the pharmacy no prescription required.