> In our own dpts, Rob is correct, we still get the juniro H.S. denying
> analgesia to abdominal pains and prescribing Pethidine when it has
been
> demoisntrated that its half life is short and that induces a lot of
nausea.
What would you recommend instead? Just use morphine + antinausea?
> It is our specialty that needs to start chalanging all these oudated
> practices and to start presenting evidence so that the profession at
large
> changes and moves forwards.
Your comment prompted me to consider. I know my reflex action would
currently be to think pethidine - but that is partly because all the
HOs and SHOs seem to suggest that when teaching/treating.
I had a quick look in the yellow bible (Ox Handbook of Clin Medicine)
and think I have found the answer. Throughout the pages on both the
acute abdomen and also acute appendicitis, analgesia is not mentioned.
The implication in teh former being, that until a diagnosis is made
you shouldn't start treating with analgesia.
I've caught on that this is wrong, but as I'm sure you are aware
surgical aphorisms are retained with great vigor. When (on the ward)
you reach for a reference book which doesn't alter that idea - it is
no suprise analgesia is so poorly managed in these situations.
Neil Iosson (Final Year Medical Student)
==
.................................................................
Neil Iosson Tel/Fax: (01223) 569015
Gonville & Caius College [log in to unmask]
CAMBRIDGE, UK
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