How many can give pain meds for abd pain?

[spenac]

Yeah, I realised that after the editing time limit. :oops:

Sorry about that. I got this topic confused with the other pain control topic, below.

No problem thanks for any input.

[ERDoc]

I was always taught that you should not give any narcotics to patients with abdominal pain because it could alter their exam and it could also prevent them from consenting to procedures. I have had ED Docs give me orders for Toradol for renal colic/pain.

I addressed the myth that you cannot give narcs to abd pain pts earlier in this thread (or it may have been the other one). It has been shown to not be true. It actually helps improve the exam and relieves your pt's suffering. Not giving them is cruel and anyone who tells you different obviously has not been reading the literature. Toradol is good for renal colic, but it is even better to give toradol and morphine. Again, recent studies have shown the benefit of using both.

In the system I volunteered in, ALS personel carried morphine and valium, but needed medical control orders to use them (I think the exception might have been an initial dose of valium for seizures, any after that required contact).

[Medic26]

My point is -- and no offence intended to 1EMT-P, whom I like -- is that I am tired of all the, "Well, my instructor says this..." and "our protocols say that..." we read around here. I want to know what my fellow professionals think, not what their protocols or teachers said. If I cared about any of that crap, I'd just pick up the Brady book everyday instead of coming to EMT City and sharing ideas with my peers.

Damn Dust I like you more every day

As far as giving narcs to belly pains, we still have alot of old school docs that have yet to see the light. But, we still keep plugging away and someday the old school will be us and what we do today.

[1EMT-P]

I do not feel comfortable giving narcotics to patients with abdominal pain. Especially if the patient has acute pancreatitis or renal failure.

[ERDoc]

I do not feel comfortable giving narcotics to patients with abdominal pain. Especially if the patient has acute pancreatitis or renal failure.

Why?

[1EMT-P]

I do not feel comfortable giving Morphine Sulfate to patients with abdominal pain for the following reasons: 1. If a patient has acute pancreatitis Morphine Sulfate may cause constriction and/or spasms in the Sphincter of Oddi increasing the patient's discomfort. 2. You also have to be cautious about giving Morphine to patients with abdominal pain, biliary tract dysfunction, gastrointestinal obstruction and/or renal function. 3. Morphine is contraindicated in patients with known and/or suspected paralytic ileus.

[Dustdevil]

I do not feel comfortable giving Morphine Sulfate to patients with abdominal pain for the following reasons: 1. If a patient has acute pancreatitis Morphine Sulfate may cause constriction and/or spasms in the Sphincter of Oddi increasing the patient's discomfort. 2. You also have to be cautious about giving Morphine to patients with abdominal pain, biliary tract dysfunction, gastrointestinal obstruction and/or renal function. 3. Morphine is contraindicated in patients with known and/or suspected paralytic ileus.

It took you a week to look all that up?

[1EMT-P]

Dust I was out of town and just got back, but thanks for asking.

Happy Trails,

1EMT-P

[ERDoc]

I do not feel comfortable giving Morphine Sulfate to patients with abdominal pain for the following reasons: 1. If a patient has acute pancreatitis Morphine Sulfate may cause constriction and/or spasms in the Sphincter of Oddi increasing the patient's discomfort. 2. You also have to be cautious about giving Morphine to patients with abdominal pain, biliary tract dysfunction, gastrointestinal obstruction and/or renal function. 3. Morphine is contraindicated in patients with known and/or suspected paralytic ileus.

There is absolutely no reason not to give pain meds to someone with pancreatitis. You are confusing this with pt with bile duct stones. Morphine has been accused of casuing spasm of the sphincter of Oddi and has been thought to cause problems in common bile duct stones. In the age of ERCP this is really not an issue. You are only doing your pts a disservice if you are not treating their pain. The only true contraindications for morphine are hemodynamic instability and morphine allergy. In someone with ileus you need to be cautious, but you also need to treat the pts pain. Like I said, to withhold pain meds from someone in pain is criminal.