Sabsaf123 Posted July 6, 2015 Share Posted July 6, 2015 So I shadowed in an ER recently and I was suprised to see how quickly pain can go down after being given pain meds in the ER. The patient came in with a pain near 8-9 and felt like a 3-4 like 5 mins after being given pain meds. Is this a common occurrence you guys see in the ER? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted July 6, 2015 Administrator Share Posted July 6, 2015 Unless it was parenteral pain meds, that's probably not a pharmacologic reaction. What did you specifically see? Link to comment Share on other sites More sharing options...
Sabsaf123 Posted July 6, 2015 Author Share Posted July 6, 2015 Unless it was parenteral pain meds, that's probably not a pharmacologic reaction. What did you specifically see? I saw a lady with abdominal pain, I think because of gallstones, and she went from severse pain to like no pain in 15 mins. Is that not common? Link to comment Share on other sites More sharing options...
primadonna22274 Posted July 6, 2015 Share Posted July 6, 2015 Had nothing to do with the pain meds. Biliary colic is just that--COLICKY pain--crescendo-decrescendo, and cyclic. You probably saw her at the top of her misery scale and then it settled down. Sent from my SAMSUNG-SM-N910A using Tapatalk Link to comment Share on other sites More sharing options...
Sabsaf123 Posted July 6, 2015 Author Share Posted July 6, 2015 Had nothing to do with the pain meds. Biliary colic is just that--COLICKY pain--crescendo-decrescendo, and cyclic. You probably saw her at the top of her misery scale and then it settled down. Sent from my SAMSUNG-SM-N910A using Tapatalk Well I also saw others types of patients with pain. One lady had some type of disease that made it difficult to pee and another also had abdominal pain. Both went from like an 9 to a 3-4 in less than 30 mins. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted July 6, 2015 Moderator Share Posted July 6, 2015 Well I also saw others types of patients with pain. One lady had some type of disease that made it difficult to pee and another also had abdominal pain. Both went from like an 9 to a 3-4 in less than 30 mins. dilaudid and fentanyl work very well when used appropriately. Link to comment Share on other sites More sharing options...
Moderator ventana Posted July 6, 2015 Moderator Share Posted July 6, 2015 IV meds work great yes real pain correctly managed does get better that fast BUT every drug addict wants these same meds.... Link to comment Share on other sites More sharing options...
primadonna22274 Posted July 6, 2015 Share Posted July 6, 2015 Yes, IV opioids work quickly, usually in 20-30 minutes depending on the drug, but not that quickly. Sounds like you are very early in your health care experience and this is good --keep your eyes and ears open and you will learn a lot. Sent from my SAMSUNG-SM-N910A using Tapatalk Link to comment Share on other sites More sharing options...
SHU-CH Posted July 7, 2015 Share Posted July 7, 2015 Toradol for a kidney stone can be like magic for some patients. Link to comment Share on other sites More sharing options...
SHU-CH Posted July 7, 2015 Share Posted July 7, 2015 Come to think of it, there are a lot of things that look like magic in the ER, particularly resurrecting someone with Narcan or an amp of D50. But I still think the best is giving benadryl to someone with an oculogyric crisis. It feels like a successful exorcism. Link to comment Share on other sites More sharing options...
SocialMedicine Posted July 7, 2015 Share Posted July 7, 2015 placebo goes a long way. so many examples of this. it reveals the power of our own mind over pain. one example. many will remember the well structured study looking at acupuncture for back pain. many who had sham acupuncture felt relief of pain as well. Link to comment Share on other sites More sharing options...
Soulfari Posted July 7, 2015 Share Posted July 7, 2015 "Better living through chemistry" Link to comment Share on other sites More sharing options...
LKPAC Posted July 7, 2015 Share Posted July 7, 2015 One lady had some type of disease that made it difficult to pee You're in clinicals and you don't know more about your patient's condition than this? This is why I believe in good, true HCE prior to PA school! Link to comment Share on other sites More sharing options...
GreatChecko Posted July 7, 2015 Share Posted July 7, 2015 I was under the impression that the OP was shadowing in the ED. This doesn't sound like someone that is in their clinical year to me. So I shadowed in an ER recently... Link to comment Share on other sites More sharing options...
LKPAC Posted July 7, 2015 Share Posted July 7, 2015 I was under the impression that the OP was shadowing in the ED. This doesn't sound like someone that is in their clinical year to me. good point. I withdraw my sarcastic twit tone. However, I still maintain the need for good HCE prior to PA school! Link to comment Share on other sites More sharing options...
GreatChecko Posted July 7, 2015 Share Posted July 7, 2015 good point. I withdraw my sarcastic twit tone. However, I still maintain the need for good HCE prior to PA school! I completely agree! I would have been lost without it and built so much of my knowledge, skills, and abilities onto it. Link to comment Share on other sites More sharing options...
sk732 Posted July 8, 2015 Share Posted July 8, 2015 I agree totally SHU-CH...it's almost like waving a wand and will definitely get you on someone's Christmas card list. Done that a couple of times - makes for a satisfying shift. Though not an oculogyric crisis, I remember my first week on psych when we had a consult for a patient "writhing on the floor in pain" who also incidentally had poorly controlled schizophrenia that the medical floor RN's were liberally dosing with Haldol. Walked up, saw a dude with wax face, arms stiffly flexed at 90 degrees, shirt off, wandering out to the corridor, lying on the floor for about 30 seconds, walking back and sitting on his bed, repeat ad infinitum. He'd politely excuse himself as he walked by. My attending tried moving his arms, got up wandered out to the nursing station and promptly reamed the charge a new one since dude was totally akithetic. Had a recent encounter at a code white with a similar problem - they looked at me like I was a four headed alien when I asked for Benadryl or Cogentin instead of Ativan. This dude had so much dope on board it took about 3 days to settle him, since they kept adding Haldol on Haldol. Still irritates me how people give meds without being able to recognize serious side effects...especially in the last case, since it literally ended up in a CQB situation. SK Link to comment Share on other sites More sharing options...
jtmathew Posted July 8, 2015 Share Posted July 8, 2015 Come to think of it, there are a lot of things that look like magic in the ER, particularly resurrecting someone with Narcan or an amp of D50. But I still think the best is giving benadryl to someone with an oculogyric crisis. It feels like a successful exorcism. Ill never forget pushing D50 into a patient with a glucose <15. Resurrection is an appropriate term. Guy sat straight up, wide eyed, wondering who the hell we were and what was going on. The practice of medicine is paved with excitement. Link to comment Share on other sites More sharing options...
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