Drug Seeker Antics and Dramas

[SWFlorida]

They are an everyday event in almost every ER around the country. What is the drug of choice in your area? I've noticed around here it is Vicodin.

Our latest little treasure was an ex RN who was a daily event in our ER. She would come in complaining of backpaid and demand a shot of demerol and a script for Vicodin. Her MD's (She had many over the years) refused to see her. We kept a lot of documentation on her antics in order to confront her with her possible little problem. Well the big day came, she didn't take it real well. She stormed out of the ER, went around the building, came in thru the main lobby and straight to a pay phone. She called in a bomb threat to the ER. The police tracked her down, they could hear the hospital pages in the background. She is now in a facility.

[Stitchie]

{{{{{ang75}}}}

Yes I totally understand. Many times I wished for Dr Kovorkian to be on duty but alas....it was not meant to be :chuckle

NS and Benadryl? Whatever. It never worked for me. If it worked for others, hats off to them. Like I said before, by the time I get my butt into the ER, I'm dehydrated, heaving, pissed off, depressed and in so much pain (after 72 hours) I want to be euthanized. I just pray that there's a doctor and nurse that understands me on shift that night. Like I said before...I even have a letter from my PCP that states I sometimes need to come into ER for pain control...but....they probably don't beleive me. WHY????? :stone

One of the docs I work with swears by Compazine IV and fluids -- a dopamine agonist thing. It seems to lessen the pain for some ppl. He's very smart, calm, experienced. I've seen DHE also used with fewer positive effects.

Next time perhaps you could suggest it.

He is a really good doc; I made a serious med error and he didn't rip me a new one; just said 'no worries, right now, if his bp climbs we'll start nipride'.

Good luck. Migraines are a terrible experience.

[ang75]

We had a ff that came in at the age of 24 for pain meds for "knee pain" . MS was the ONLY thing that worked of course. No limp, normal gait, dnv's intact, no crepitus, nada. One of our ER docs got so tired of her that he just snowed her. I wasn't taking care of her, but I walked by the room shortly after her pain meds were given and she was drooling all over herself. I freaked out! Not saying that what he did was right, but it was effective. Didn't see her for a year after that. I have no idea what he ordered or how much but he apparently got what he was looking for.

[z's playa]

One of the docs I work with swears by Compazine IV and fluids -- a dopamine agonist thing. It seems to lessen the pain for some ppl. He's very smart, calm, experienced. I've seen DHE also used with fewer positive effects.

Next time perhaps you could suggest it.

He is a really good doc; I made a serious med error and he didn't rip me a new one; just said 'no worries, right now, if his bp climbs we'll start nipride'.

Good luck. Migraines are a terrible experience.

In the States, I think Compazine is an anti emetic right? Well here we have Maxeran which is also an anti emetic. I get that all the time. It too makes me jittery but only when mixed with certain things. I seem to be real sensitive to the jitters and I'm talking shaking crawly jitters. It works well at onset but not very much later on. Thanks for the tip :)

[z's playa]

We had a ff that came in at the age of 24 for pain meds for "knee pain" . MS was the ONLY thing that worked of course. No limp, normal gait, dnv's intact, no crepitus, nada. One of our ER docs got so tired of her that he just snowed her. I wasn't taking care of her, but I walked by the room shortly after her pain meds were given and she was drooling all over herself. I freaked out! Not saying that what he did was right, but it was effective. Didn't see her for a year after that. I have no idea what he ordered or how much but he apparently got what he was looking for.

A little alarning..a little alarming... :uhoh21:

[galenight, BSN, RN]

Even though we've gotten a bit off topic here, I'm going to throw my two cents in. I am also a migraine sufferer, as well as fibromyalgia, and some pretty hefty arthritis (the one in my back courtesy of a work related back injury, but that's neither here nor there). Anyway I also have tension headaches. I am in pain 24/7. I have been to the ER once for a migraine. I was driving home from work and had a bizarre taste in my mouth, sudden onset of 10+ pain in my left eye and I was seeing pink around the edges of my vision. I was treated with.....(drum roll please)..... O2. yes... high flow O2.. until I had peripheral numbness and tingling. I did, however tell the docs no narcs, since I had to drive home and get kids as hubby at the time was out of town. I have been to the renowned Diamond Headache Clinic in Chicago (an 8 hour drive), have been on many abortives and preventatives including antidepressants, Lopressor, anti seizure meds and others. About the only thing that ever works for me is Toradol 60mg IM. I self administer at home. If caught early I'm good to go. If not, I suffer through. I am fortunate to not have nausea or vominting most of the time. Anyway, I'm not quite sure what my point was, but to put my 2 cents on migraines in.

by the way, the drug of choice in my neck of the woods in Vicodin... oh.. and could you make that ES please, the plain doesn't touch me.

Also have many elderly on Duragesic, PLUS oral analgesics such as vicodin, fioricet etc.

[ang75]

We use O2 for "cluster headaches". Works wonders.

[teeituptom, BSN, RN]

We use O2 for "cluster headaches". Works wonders.

except when they really want dilaudid

[ang75]

exactly tee it up tom!

[kids]

except when they really want dilaudid

Having recently been the recipient of a Dilaudid PCA...I can NOT magine why anyone would actully want the stuff...yuck.

[vablueyes]

In our ER, the frequent flyers are presented with a letter from the ER Director, saying that while they may have real migraine headaches, their efforts to find relief have been too frequent in our ER. So, they will not get any narcotics (although toradol and tylenol will be administered) until they present back with a letter from a neurologist or pain clinic stating that they have been evaluated. You wouldn't belive how effective this has been. It is a very nice way to say we don't believe you, but will treat you if you come to us. But, if you want the big guns, you need to play by our rules.

[teeituptom, BSN, RN]

Having recently been the recipient of a Dilaudid PCA...I can NOT magine why anyone would actully want the stuff...yuck.

I dont understand it either

but they do

[MEME_BSN]

At my hospital we have a social worker specifically for the ED she creates care plans for frequently fliers. She has been very successful at detering those that abuse the system and getting them help elsewhere and in the community. For some pt the requirement is that they must call their pvt doc first before coming to the ED. It gives people accountablity.

The social worker is awesome she has saved the hospital over 3 million dollars!

MEME