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REPORT ABUSIVE REPLY
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Message Subject
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Is a Really Bad Toothache the Worst Pain There Is?
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Poster Handle
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Anonymous Coward |
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Post Content
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In the ER pain meds are used when needed but there is always the fear of someone overdosing or using it for recreational uses.
The three things that will cause an ER to trot out the big guns (morphine/demerol/dilaudid) are:
Kidney Stones: This calls for enough Morphine that the patient is barely awake. You can get them to respond if you talk to them, but if you don't they zone off into their own little pain free world, if the dose is high enough. BTW: the patient should be on Oxygen level monitoring for the first few hours to make sure they don't forget to breath (overdose in other words.)
Testicular Torsion that cuts off the blood supply to the testicle. If this isn't repaired surgically in a few hours the testicle will die. The pain is horrible and can only be partially relieved unless you knock the patient out with morphine and demerol, and then repeat every time they awaken until the surgeon gets here.
Tooth abscess with high fever and wbc that confirms a serious infection. Normal treatment is to begin IV antibiotics and let a liter or two trickle in. Then switch the patient to oral doses of the same antibiotic. Also give them Morphine or Demerol in the drip or do an IV push of it. And when they're ready to go home, give them some IM steroids to reduce the inflammation or the inflammatory response. If the MS doesn't cut this kind of pain, then a four MG push of IV dilaudid (Hydromorphone) will do it. The room spins around, you feel sick to your stomach, and suddenly you're floating and the pain is WAY down there someplace behind you!
I despise docs who will hand a patient an RX for percoset and know full good and well that percoset is not going to touch this kind of pain. Why do doc's do this? Because they're afraid to use real drugs for fear of censure by the hospital staff.
Personally, i use what it takes to stop suffering. And I do not give a shit what my peers think. My purpose is to alleviate suffering and the narcotics can usually accomplish this in the right dose and repeated often enough.
I once had a woman brought into the ER with a gurney embedded in her stomach all the way thru to her spinal column. She had been "almost" cut in half. There was NOTHING we could do. She was dying. Her husband was called and arrived minutes after she did. We loaded her up on huge doses of Morphine so they could say goodbye and have their final moments without the pain being the only thing she was aware of. I gave her enough MS to kill three people and she chatted calmly for about 30 minutes before her BP started to drop. Then she told her husband she was sleepy, and kissed him one last time. She closed her eyes and died. As deaths go, it was a very peaceful one for both of them. Two days later I was subjected to a hospital board inquiry about the amount of MS I'd given her. Yes, it could have killed her. But then again, there was no other outcome from her injuries other than death. Medicine had nothing to offer her except a bit of pain control for her last 1/2 hour on this earth. Her husband came to testify before the inquiry board on my behalf. They backed down. I'd threatened publicity and major press coverage and her husband threatened the same. I did what was morally correct and gave her an easier and pain-free exit. She had the time to say goodbye to her husband and he didn't remember her last moments writhing in pain, but rather of a calm, sane woman knowing full well she was dying and able to say goodbye to her spouse and tell him that she loved him and always would do so.
But the witch hunts hospitals are afraid of narcotics even in cases like hers. I asked the hospital director that, if he was literally cut in half all the way to his spine, how much morphine would he want used? His response was "as much as it took to stop the pain!" I said - "even if that dose could end your life?" and he said "Yes, without a doubt. There was no longer a "quality of life" issue left. It was all about stopping pain long enough to allow them to part in peace. I did that, but paid one hell of a price for it for a few weeks during the inquiries.
I was exonerated of all wrong doing in the end. But to think that I could have lost my medical license had things gone the other way - it's absurd. Butt welcome to narcotic pain management in America. It nearly doesn't exist outside of pain centers, and/or hospice care...
Quoting: Anonymous Coward 642285It's sad, I really think the docs are afraid to treat you in an emergency room. It's now such a litigeous culture, we've lost our edge medically and socially. I feel sorry for old people and I feel sorry for people in the convalescent business. I don't know how anyone can make it at anything these days with the government and the lawyers and the insurance.
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