My Pain Response
Peter Canning wrote a post on his Streetwatch: Notes of a Paramedic blog on the new pain protocols under which he was operating. He pointed out how the new dosing schedule offered an opportunity to better treat pain. He then alluded to an article about a pain management doctor who was arrested for over prescribing pain meds. Check out his post for the details.
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Peter had an anonymous comment about “nobody ever died from pain” and that docs should be focused on healing the underlying problem and not resorting to long term pain management.
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I had to respond and here are my comments:
I have to disagree. People “die” of pain all of the time. Continuous chronic pain of even a low level affects sleep, work performance, and overall health including immune response. People who are left untreated for pain experience longer recovery times and higher mortality rates.
By the statement of “anonymous” above, an arthritis patient who can’t get out of bed in the morning without the use of strong analgesics (pain meds) should just tough it out and deal with the inability to function productively without pain management. This person should leave their job because they can’t use their hands some days or walk long distances. They should just quietly starve while enduring their uncurable condition until — oh yeah! They die!
Pain is deeply personal and what is extremely painful for one patient is minor to another. We as medical providers must be careful not to place our own personal pain template over another’s injury. This is why we use the 1 to 10 scale for pain assessment. It gives us a scale to judge the patient’s discomfort and to re-assess pain management effectiveness.
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A bit of a soapbox moment for me but I think the point needs to be made. Whether the pain is acute or chronic in nature, we do our patients a disservice by not treating their pain. There have been many studys done on the adverse affects of untreated pain and I have covered pain management before in this blog and on my podcast.
Filed under EMS On the Side by on Jun 25th, 2007. Comment. 
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Comments on My Pain Response
We have to be diligent in our assessment of every patient; however, we all see those patients that we know only called 911 in an attempt to get more meds to get “high”. I have known medics who wwere addicted to Lortabs just because they liked the feeling they got from taking them, not because they were in pain. Then there is the extreme in which patients even have injectables at home. I ran a call a few years back in which a 30-something female patient suffered from chronic back pain so her personal physician had prescribed IM Demorol and Phenergan PRN q 4 hrs. She was unresponsive and resp. were shallow. She had a HUGE area on her thigh where she had been injecting. Narcan worked wonderflully after intubation. Sadly, nothing was done about the physician or her problem. About a month later he gave her a central line and some Morphene and sent her home. Needless to say she didn’t last long and that time she didn’t make it. The physician, by the way, still has his practice. I am very generous with pain meds for those whom I know are really in distress, but I am concervitave with those who are in questionable need of pain relief.I think that we should be part of the solution in those cases to find better ways to treat the pain rather than to hand out narcotics.