Paramedics: Chronic Pain

Being transported to a hospital in an ambulance as a CPer, I have found that is all they do is transport, medication is only assessed once in ER, otherwise the staff are very friendly and helpful, one thing that can be improved but is out of your hand is waiting times.

Don

Hi Rye,

Welcome to the CPA forum.

I need to ask you a question. Are you conducting a survey?

If you are, then please stop and approach the organisation in the correct manner, which will be to send me an email requesting a form to fill out, then fill out the form and send it back and it will be assessed by our committee and they will decide whether to give you permission or not and where to post your survey on our website. It won't be posted here on the forum.

Email address is: national.office@chronicpainaustralia.org.au

If you are simply after a bit of information and are NOT conduction a survey, then you are welcome to ask some questions, providing they are not too many.

Sorry for the authoritarian response to your post, but we are constantly harangued by spammers and people pushing their own products, trying to sign our members up for snake oil treatments. And we ban them all immediately now!

We are very happy to help out any allied health professional. We just need to know your intent.

And as you will have guessed by now, we guard our members well, because some of them may be vulnerable. We keep this forum for their support only. It isn't for people running surveys or selling products, or running political campaigns.

End of lecture!

Peter

No, Peter, I am not. This is out of purely self-interest. I'm not offering anything, I'm looking into what prehospital cares are provided to chronic pain patients. I have heard many 'through the grapevine' stories of pain relief not being administered, or being denied to a patient. My mother has encountered it.

She has CRPS T1 affecting her left side (below the breast) and left arm. When we have called 000, paramedics usually respond and think the worst, as they should. Giving her a full ECG and cardiac workup, for example, but have often lacked when it came to pain relief or really... any interest in my mothers condition. I was wondering if anyone else has encountered this. I'm a student; planing on doing some group assignments around chronic pain and real cases help put things into perspective. Thanks and sorry if I set off alarms.

No problems Mate. You just have to understand that we need to protect this forum and I'm just doing my job. No offence intended!

CRPS is a cow of a thing and most people who get it, suffer badly and don't get the same support as chronic pain sufferers do, even though many of the CP sufferers get little support too. Although things are much better today than they were 10/15 years ago, we still have a long way to go.

I have never been taxied off to hospital in an Ambo so I can't help you there. We might get some others come in here later who might be able to answer your questions.

I took the liberty of adding a ? to your thread title, so that it might attract more attention from our readers.

Peter

Thanks Peter, no offense taken and again sorry for the alarm.

Thanks for the reply Grappers. I have heard that quite a bit, the waiting times can be awfully long. Paramedics in most states, though, if they are paramedics and not transport officers (Ambulance Officers, etc) should be able to assess pain and give pain relief if appropriate. Some may hold off not to mask the pain or in certain circumstances. None the less that's probably why paramedics are voted the most trusted healthcare profession; we get things done, and quickly, and can combat pain.

In my experience, once they (and I'm lumping all medical professionals in here) discover you're already under pain treatment programs, its all hands-off and useless.

I've fronted the ED in so much pain (Spinal CRPS) that I can barely stay upright and the attending refuses to either treat or admit and recommends going to see my pain specialist.

That's not good Aetherone. It's obviously a few drug seekers who are making things difficult for everyone else. I wonder if you carried a letter from your pain specialist outlining your needs if it would make any difference? There must be a solution to this somewhere.

Mary

If you have a strong pain you can take some drug for a quick refile but it not a permanent solution for your pain. You want a permanent solution for your pain do some exercise in early morning for few month or take some proteins.
How Teeth And Diet Cause Back Pain

Hi Rye,
It is nice you recognise that there is a need of improvement.
In Perth the ambos can offer an injection, I believe it is a benzodiazepines based one. They offered me one once but I chose to go to hospital as I want monitoring for breathing and if is gets worse.
I suggestion would be to carry a 30 and 10 Toradol injection IM. As I find it is very effective, for me, and being a S4 drug you could administer. Again this would only be appropriate if it was used before and proved to be effective in that patient.
Regards Paul

Hi,
A useful tip. If my pain spikes out of control. Usually at least once a year. And I have to go to ED. I take a bag full of my meds, opiates. To prove I am not drug seeking, and I ask for a Toradol 30 IM injection, which is a steroid based medication used for severe post op pain, in me, it works highly effectively, and being an S4 non opiate they are quite willing to use it. The first time I went to ED they treated me like a drug seeker and I was appalled. So from then on I take my opiate medicine with me to prove I have not run out and I don't ask for any. You cannot use Toradol frequently because of stomach ulcers and bleeding but for rare use it is very good, for me. I use Toradol, your doctor can prescribe it for very severe break through pain, and for when I go on a plane flight, about once a year, or if I was going on a bus trip, longer than 4 hours. I hope this helps you and other people, remember that it might not help and everyone reacts differently to medication and pain is different in everybody. Now I have a Toradol 30 IM at home so I can use in a emergency. So my hospital trips are far less. It comes in tablet form too but it causes gut problems. Discuss with your Doctor. IM is intramuscular injection, in the butt.
Regards Paul

Pain letter is a great idea, I take some opiate medicine with me to prove I did not run out, and I ask for a steroid solution to the pain, then they are more receptive to me.
Regards Paul

Ketorolac: An Extensive History of Pain Relief
Ketorolac is a hospital-strength nonsteroidal antiinflammatory drug (NSAID) that has been available for over 20 years.1 A nonselective NSAID, ketorolac inhibits prostaglandin production by inhibiting COX-1 and COX-2.2,3 It has potent analgesic activity,4 and has been extensively studied in postoperative patients.5
POPULAR PARENTERAL ANALGESIC
Ketorolac was the first NSAID approved in the United States for parenteral use as an analgesic.5 Premarketing clinical trials involving more than 5,000 patients demonstrated that ketorolac’s analgesic efficacy was similar to that of parenteral opiates in patients undergoing general and oral surgery.5
Ketorolac is widely used intramuscularly and intravenously for moderately severe acute pain: there have been more than 500 million injections in the United States since its introduction, and nearly 40 million injections in 2010 alone.6
AN NSAID ALTERNATIVE TO OPIOIDS
Ketorolac has similar efficacy to morphine and meperidine.7 A 30-mg dose of ketorolac IM delivers pain relief equivalent to that of morphine 6 mg to 12 mg.8
In two double-blind studies of postoperative patients with moderate to severe pain, IM ketorolac injection was compared with meperidine or morphine IM, and IV ketorolac was compared with morphine administered intravenously or via patient-controlled analgesia. During the first hour, the onset of analgesic action was similar for ketorolac tromethamine and the opioids, but analgesia lasted longer with ketorolac tromethamine.7
Clinical studies have also demonstrated that combining ketorolac and opioids significantly reduces the need for morphine.9,10
KETOROLAC IS NON-NARCOTIC
As an NSAID, ketorolac does not bind to opiate receptors.8 A study to evaluate the sedative and addictive potential of ketorolac showed no withdrawal symptoms upon cessation of dosing with ketorolac 30 mg IM four times daily for 5 days.8 Ketorolac IM also has no significant adverse effects on psychomotor measurements, including reaction time, computerized driving skills, ataxia, and sedation.8