MORPHINE

Walked in the door and the buzzer went off. 100 year old lady tripped in the dark during the night and broker her arm. She said her pain wasn't bad as long as she wasn't moving her arm. I asked her if she wanted any morphine and she said no. She was a very proper old woman who had spent her life at an upper class country club and who had quite high social standing.

I have been doing a lot of thinking about pain relief. There are two groups of patients I would like to help tht I feel are being neglected. The group that says that are allergic to morphine and the group that on hearing the word morphine, immediately says no. The first group is broken down into those truly allergic and those who just get nauseous. The second group thinks either they are not hurt enough to have to get MORPHINE or that Morphine will turn them into skanked out junkies. I think the 100 year old lady was in this group. Proper ladies do not partake of morphine under any situation.

I am working with the head of medical advisory committee to try to get us to carry another drug -- either tramadol or possibly nubain that would enable some relief to these people. What I did do the other day with someone who said they were nauseous whenever they got morphine was to pretreat them with phenergan and that worked really well. I'd just like to be able to provide relief to everyone. I suppose I could have just told this old lady I was going to give her something for her pain and gone ahead and given her a little morphine without naming it.

Other two calls were for a woman with a fever and a chest pain and a woman who took twice the dose of a diet pill and felt her heart racing. I thought it was a bit of a BS call, but when I did a monitor, she had flipped T's in the inferior leads. How that compared with her old ECG, I don't know.