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These authors read far too much into their limited study – Part I
- There is a new study that looks at prehospital fentanyl. It starts out well, it is even randomized, blinded, and prospective, but it loses focus and draws conclusions that are not remotely justified...
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These authors read far too much into their limited study – Part II
- Continuing from Part I. The authors do not find dramatic differences between fentanyl and morphine in their ability to relieve pain in patients who are not hypotensive. In the discussion, they begin...
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Geriatric patients may not experience increased risk of oligoanalgesia in the...
- The current Annals of Emergency Medicine has an editorial and two studies of pain management in older adults. One study is a 10-year prospective, observational study of a convenience sample of...
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If the patient is asleep, does that mean that the pain is gone?
Is it appropriate to stop giving pain medicine just because the patient is asleep? My little burned patient was probably not expressing relief from pain with her periods of unresponsiveness –...
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Dilaudid – Start With 2 mg or Start With 1 mg?
What is the proper interval before we should give another dose of opioid to patients who still have significant pain? The authors of this study suggest that 3 to 5 minutes would be ideal, but that...
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Where is the Line Between Good Pain Management and Bad
Almost everything exists on a continuum. Pain management is no different. The idea of completely good, or completely bad, pain management may not even be appropriate in describing the extremes,...
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Is It Wrong To Medicate To The Point Of Needing Ventilation – Question from...
Image credit. In the comments to Where is the Line Between Good Pain Management and Bad, mpatk write the following – To clarify, would you consider it acceptable to sedate to the point of...
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Safety of Intranasal Fentanyl in the Out-of-Hospital Setting – A Prospective...
I have been very critical of plans to have first responders treat people they suspect of having a heroin (or other) opioid overdose with naloxone. Would first responders be safer with fentanyl? It...
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Is It Possible To Be Alert And Oriented With 10/10 Pain – Part I
Unfortunately, with my protocols, an altered level of consciousness prohibits me from giving opioid pain medication on standing orders for burns or for musculoskeletal trauma. I can call command...
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Are there reliable objective assessments of severe pain
– What are the vital signs that we need to see to know that the patient has severe pain? Here are the vital signs from a study comparing treatments for severe pain.[1] – – These patients had an...
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Is It Possible To Be Alert And Oriented With 10/10 Pain – Part II
– Continuing from Part I. Unfortunately, with my protocols, an altered level of consciousness prohibits me from giving opioid pain medication on standing orders for burns or for musculoskeletal...
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One Example Of Why Treatments Without Evidence Are Dangerous
– Homeopathy is just a fancy way of selling placebos. Pure deception. Dilution to remove the possibility of any medical benefit. That just makes it harmless, right? Wrong. Magical thinking is not...
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How to Torture Patients
– Perhaps, you have watched all of the parts of Saw and wished that you could have some of that kind of fun, too. Even though we are supposed to be having the opposite effect on patients, some of us...
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What is a Holistic Pain Management Doctor?
– A woman being treated for a painful condition is refusing pain medicine, because it conflicts with her beliefs. That is her choice, but she is reported to be in school learning to treat people for...
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Comment on What is a Holistic Pain Management Doctor? from Divemedic
– Divemedic of the wonderfully named Confessions of a Street Pharmacist responds to my criticism of the failure of pain management by someone who preaches that real medicine is evil.[1] – – I attended...
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The 4 ‘Ws’ of Pain Management – a discussion at First Few Moments
– On the latest First Few Moments[1], Kyle David Bates hosts Brad Buck, who through an unfortunate Skyping accident we lost, Wilma Vinton, Roland Rolfsen, Dr. Laurie Roming, and me in a discussion of...
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Six EMS Phrases That Should Be Banished
– At The EMT Spot, there is an excellent discussion of phrases that are used, and abused, by those of us in EMS. Here are some of these begging to be banished phrases, a few of which I view a bit...
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Pain Management and Comfort Care
– Peter Canning has been counting down the 16 Most Significant EMS Treatment Changes in My 20 Years as a Paramedic and he has #1 as not just pain management, but also comfort care. In spite of all the...
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Acupuncture vs intravenous morphine in the management of acute pain in the ED
What does elaborate placebo mean? An elaborate placebo is a placebo that does better than a pill, or injection, apparently because the patient has more invested in the belief the placebo will work....
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The Medical Journal of Australia is Scammed by Acupuncturists
Also to be posted on ResearchBlogging.org when they relaunch the site. Acupuncture has been thoroughly studied in high quality studies. The result is that we know, yes we know, that acupuncture is...
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