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Brent:
I absolutely
agree with the previous posts on this subject. We encourage our crewmembers to
administer pain medication, even though we've had to run interference with
some receiving physicians who don't yet agree with recent research that seems to
refute old doctrine. We use primarily fentanyl, for it's shorter duration and
lack of hemodynamic side effects. As one other poster stated, we aim for making
the pain tolerable without altering mental status. Mental status is documented
before and after meds, and this is communicated in patient report. We do also
try to remind our folks that paralyzed patients hurt too!
I'd be more
than happy to speak with any medical director on this subject if it would
help.
Laurie Romig,
MD
Bayflite, St.
Pete, FL
Question for the group. I recently attended a
conference and spoke to a flight RN from another program regarding sedation
and analgesia for intubated and non intubated patients. I was very surprised
to learn that in her program they are not allowed to give analgesia to their
intubated patients just sedation. The scenario she gave me was a MVC large
amount of trauma -head face chest. RSI intubation and on the flight home with
stable vitals no pain meds. They also don't give pain meds to unintubated
trauma patients. I was wondering where the rest of you stand on this
with your programs. I asked if she would mind if I listed this post and she
was OK with it as long as no names were involved. We routinely give pain
meds to anybody in pain regardless of the disease at hand. I do realize
the trauma team likes a good neuro assessment but pain is pain. Also I
checked with numerous anesthesia practitioners who all stated that they
give narcotics as well as sedation to any intubated
patient.
Thanks for your time
Brent
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