 |
 |
Paul , Almost right. If it happens to you, then to me it is an anecdote. If it happens to me it is a whole lot more significant than a mere anecdote, it becomes an experience. My coleague tells a similar story. Given Morphine for a "local" unpleasntness he managed to vomit to Mallory Weiss proportions. In answer to your last point I suspect it is because it seems to work and is easy to spell. I have never heard of this other stuff but I have stopped Stemetil. JP >>> Paul Bailey <[log in to unmask]> 06/11/01 12:11pm >>> John, so when you say "That was quite a useful trial I thought" you actually mean that you have had a personal anecdotal experience which has changed your practice! BTW, I fully agree with you about armchair experts. I am thoroughly convinced that the decision making process of an experienced clinician is a very undervalued commodity. Similarly, I would routinely advocate the use of antiemetics in the situation that you have described, and in which you were denied them. What I can't quite understand is why we are so hung up on metoclopramide. Regards Paul Bailey MB BS FACEM ----- Original Message ----- From: John PASKINS <[log in to unmask]> To: <[log in to unmask]> Sent: Monday, June 11, 2001 4:01 PM Subject: Re: Prophylactic metaclopramide I do understand the difference between anecdote and a controlled trial.. What was interesting about my experience was that the vomiting was violent and projectile and I was told that it was not routine to give an anti emetic. I was made to feel a nuisance for vomiting. On the third occasion I got upset and had Metaclopramide and no further trouble. My guess is that the nursing staff were paying too much attention to "evidence" from armchair experts and not enough to their patient. JP >>> Duncan Peacock <[log in to unmask]> 06/10/01 09:34pm >>> I tend to give an antiemetic such as cyclizine or metoclopramide. In trauma victims on top of the opiate effect you have reduced gastric emptying, then we tape them down. Anything that reduces "nausea", increases lower oesophageal sphincter pressure, and speeds intestinal motility is a bonus. Like not using anything "prophylactic", its fine until it happens ie they vomit +/- aspirate, then you wish you had given it. Duncan Peacock London _________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com.