But yes to analgesia ...
Every six months I persuade an SHO to do an audit of analgesia for various
fractures/soft tissue injuries, and the results are usually pretty poor.
One reason os the wait beofore seeing a doctor, with the triage nurse
'forbidden' by hospital regulations to give out even ibuprofen or
paracetamol, and I have been assured at departmental meetings that this
will be looked into. I encourage the nurses to have a pot of pills out
there for patients to take if need be. One way which i think would bring
this to light is that practised by a colleague in the U.S., who has a
painscore out of 10 as part of the set of obs which must be taken by the
triage nurse. An audit of this may just alert us that in fact our analgesic
practices are often inadequate and several hours too late.
Anyone else got good ideas ?
----- Original Message -----
From: Belsham, Philip <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, November 02, 2001 12:56 PM
Subject: Re: Say NO to drugs!
> Couldn't agree more, but you miss the point! The injury/dislocation
requires
> analgesia, but the reduction should not, if performed according to Kocker
> (not me!) - that is without any traction (Helen Cugnoni, please note!)
>
> Many surgeons are still in complete ignorance of the well proven fact that
> analgesia does not mask abdominal signs - analgesia is something that we
> should be routinely providing, by the best route, and in adequate doseage
> (that is, sufficient to relieve the pain). We often don't do this at all
> well, and even our nurses sometimes only seem to respond to specific
> requests!
>
> Philip Belsham
>
> > -----Original Message-----
> > From: Devesh Sharma [SMTP:[log in to unmask]]
> > Sent: Friday, November 02, 2001 11:27 AM
> > To: [log in to unmask]
> > Subject: Re: Say NO to drugs!
> >
> > I am happy to accept that many shoulders can be reduced without
sedation.
> > I feel that the desire not to give analgesia may reflect our own
> > preconceptions about the individual and whether he or she 'deserves'
pain
> > relief. As a specialty we have (rightly) made a big deal about the
desire
> > of some surgeons to withold analgesia until examination (a view which
> > still seems to exist). It seems to me to be inconsistent to then argue
> > that when we wish to avoid giving it for our own reasons (is a slightly
> > shorter stay in the department for these few patients really so
relevant)
> > that is OK.
> >
> > Devesh Sharma
> > SpR in A&E Medicine
>
>
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