Actually, he's really probably right. EMS suffers from dearth of pain management options. It's either nothing, or killing a flea with a shotgun (IV narcs). If I ruled the world, you'd see varried options for EMS, methoxflurane or entonox (both not approved for US use), PO and IV NSAIDS and APAP, PO narcs, IV narcs mixed with benzos and ketamine.Anyhow I get to ER and I am told by physician that it was "a little over the top" to start an IV and give morphine.
The correct attitude, and like I said, unfortunately we've got to continue to kill fleas with shotguns.Turns out pt had been prescribed plenty of pain meds and was probably drug seeking. I refuse to get into the mind set that every patient that I encounter who is in pain can just tough it out till the hospital, since they are probably lying to me anyway. I am not there to pass judgment, they initiated EMS system so I am there to help.
Maybe I should bring one of those magic 8 balls and use it after I ask each question to determine whether my pt is lying or what not.
Fortunately the physician was willing to do this. Not an inapproprite way of opperating, but one many hospitals are uncomfortable with due to liability concerns. Narcotics are not nearly as dangerous as their made out to be in emergency medicine, but they're still seen as the boogey man by many.Physician ordered IV taken out and pt sent to waiting room in wheelchair. Physician was not irate or anything but still, I am going to continue to follow protocols and if pain management is warranted I am going to do so.