The Consultant Cardiologist (Dr.Robson) at Carlisle initially introduced
diamorphine pre 1990 when he was Chairman of the Local Paramedic Steering
Group. Although the Dept of Health knew about it they did not act against
the Committee as once introduced it was difficult to explain the reasoning
behind withdrawing it to the local crews and patients! It was self evident
common sense to give the Paramedics something to provide adequate pain
relief for the patients. Cumbria was not the only Ambulance service to
introduce opiates. Of course if anything had gone wrong our heads would have
rolled ref : Sword of Damocles, 4th Century BC. see below
There has been reference to giving Morphine intra nasally, diamorphine is
superior simply because you can use a concentrated solution that is twice as
potent. I use 5 mg diamorphine in 0.5 ml of water. An intra nasal spray
would be better and I understand that this is being developed.
Colin wrote, "Cumbria Ambulance do take some unusual views when it comes to
selectively interpreting guidelines!" I think such comments need to be
explained or not mentioned, otherwise it could be seen as mud slinging. I
seem to remember a saying about stones and glass houses.
Ray McGlone
A&E Consultant
Lancaster
REF: A Sword of Damocles: an imminent danger; a constant threat, especially
in the midst of prosperity.
Damocles (4th Century BC) a courtier of Dionysius the Elder, tyrant of
Syracuse. Having extolled the happiness of royalty he was invited to a
sumptuous royal feast , but on looking upwards he saw a sharp sword suspened
over his head by a single horse hair. Thus the tryant stressed the constant
danger there is surrounding power.
----- Original Message -----
From: "Colin Hendry" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, September 30, 2001 10:46 PM
Subject: Re: Prehospital Analgesia for Children
> > This may sound like a stupid question , but i am interested in the
> > legalities of Cumbria Ambulance service use of Diamorphine, as I was
> under
> > the impression that CDs could not be given under a group protocol or
> similar
> > except in a certain set of limited circumstances which have never
included
> > ambulance services and / or diamorph.
> >
> > but if you don't ask the stupid questions you don't learn
> >
> > Martyn Hodson
>
> I believe that officially it is a trial (which just happens to have lasted
> for some time). As to how they got round the legal situation, I don't
know,
> but Cumbria Ambulance do take some unusual views when it comes to
> selectively interpreting guidelines!
> Ray is on the Paramedic Steering group so I am sure he will provide
further
> information.
>
> Colin Hendry
>
>
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