Comments on: Overtreating pain http://www.kevinmd.com/blog/2007/07/overtreating-pain.html medical blog Mon, 23 Nov 2009 01:35:28 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: ERMurse http://www.kevinmd.com/blog/2007/07/overtreating-pain.html/comment-page-1#comment-78160 ERMurse Wed, 25 Jul 2007 02:02:00 +0000 http://clients.emmense.com/kevinmd/2007/07/overtreating-pain.html#comment-78160 My experience has been in the ER. I have seen numerous near misses (patients needing reversal) and am aware of a few clean kills related to over aggressive pain management in a busy ED without the depth in Staffing to provide sufficient monitoring of the practice. I have seen numerous people who “Had a Ride” lie or sneak out and drive after being well medicated. I call in a report and turn in a DMV form when I see it happen. How do we measure how many people that has knocked off over the years on the roads by one of these Customers. Wont ever be measured and the reports will be anecdotal so it will be ignored in the pain management debate.<br/><br/>I see this problem as getting worse and now being driven by the desire to produce high patient satisfaction scores which is reflected by improper intervention in medical decisions by Hospital Administrators. My experience has been in the ER. I have seen numerous near misses (patients needing reversal) and am aware of a few clean kills related to over aggressive pain management in a busy ED without the depth in Staffing to provide sufficient monitoring of the practice. I have seen numerous people who “Had a Ride” lie or sneak out and drive after being well medicated. I call in a report and turn in a DMV form when I see it happen. How do we measure how many people that has knocked off over the years on the roads by one of these Customers. Wont ever be measured and the reports will be anecdotal so it will be ignored in the pain management debate.

I see this problem as getting worse and now being driven by the desire to produce high patient satisfaction scores which is reflected by improper intervention in medical decisions by Hospital Administrators.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/07/overtreating-pain.html/comment-page-1#comment-78147 Anonymous Wed, 25 Jul 2007 00:01:00 +0000 http://clients.emmense.com/kevinmd/2007/07/overtreating-pain.html#comment-78147 Screw the Joint Commision. No one should let them dictate how to medicate patients. Let them stick to issues like the width of the hallway and the number of trash cans. Screw the Joint Commision. No one should let them dictate how to medicate patients. Let them stick to issues like the width of the hallway and the number of trash cans.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/07/overtreating-pain.html/comment-page-1#comment-78118 Anonymous Tue, 24 Jul 2007 15:09:00 +0000 http://clients.emmense.com/kevinmd/2007/07/overtreating-pain.html#comment-78118 I was going to point out that a "sign" can be objectively assessed, pain cannot. The example of the patient awakening from a narcotic sleep and complaining of 10/10 pain is an excellent example of why it is a symptom, not a sign. But anonymous 9:37 beat me to it. I was going to point out that a “sign” can be objectively assessed, pain cannot. The example of the patient awakening from a narcotic sleep and complaining of 10/10 pain is an excellent example of why it is a symptom, not a sign. But anonymous 9:37 beat me to it.

]]> By: Anonymous http://www.kevinmd.com/blog/2007/07/overtreating-pain.html/comment-page-1#comment-78117 Anonymous Tue, 24 Jul 2007 14:37:00 +0000 http://clients.emmense.com/kevinmd/2007/07/overtreating-pain.html#comment-78117 It might help to stop indulging the idiotic notion that pain is a "vital sign." Pain is a complaint and it is an element of history. It is a symptom, sometimes. It cannot be measured objectively. Vital signs can be measured, obviously. If extreme pain causes tachycardia and hypertension, those are the things that should be measured. Smilie-face/frownie-face is for morons.<br/><br/>Stupid people and thoughtless panderers think that calling pain a vital sign makes it one. That is a disservice to the discipline required of medical decision making. It is unfortunately a result of allowing persons not fully responsible for medical decisions to say what should be important and what should not. It might help to stop indulging the idiotic notion that pain is a “vital sign.” Pain is a complaint and it is an element of history. It is a symptom, sometimes. It cannot be measured objectively. Vital signs can be measured, obviously. If extreme pain causes tachycardia and hypertension, those are the things that should be measured. Smilie-face/frownie-face is for morons.

Stupid people and thoughtless panderers think that calling pain a vital sign makes it one. That is a disservice to the discipline required of medical decision making. It is unfortunately a result of allowing persons not fully responsible for medical decisions to say what should be important and what should not.

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