narcotics

[oharnp]

I am a ARNP and work in an er. I am so annoyed with doctors telling me how to.treat pain. They tell me to start with narcs. i have my own orders which are a combo of any of the follwing meds:

Reglan

benadryl

ativan

Diazepam

ketorolac

motrin

tylenol

zofran

I do not order narcotics unless there is evidence of a painful conditon.Am i wrong. what is it like in you er

[BuckyBadgerRN, ASN, RN]

I always say that Tylenol is safe for pregnant women because it doesn't do a damn thing! =)

[ICURN3020]

I always say that Tylenol is safe for pregnant women because it doesn't do a damn thing! =)

I cannot agree with this more!!! Tylenol/acetaminophen for some reason does not work for pain or fever relief in me or my children. We go right to the Motrin/ibuprofen.

I agree that narcotics should not automatically be the first-line pain relief medication prescribed. There are many factors that should be taken into account such as diagnosis and expected pain and the patient's drug/ETOH history, if any. Do these physicians always go straight for the narcotics and never try anything else?

[oharnp]

Yes narcotics are always ordered first

[Mn nurse 22]

The world health organization has a pain analgesic ladder. It says for mild pain 1-3/10 that a non-narcotic should be used, moderate pain 4-6/10 than non-narcotic plus narcotic, and for severe pain 7-10/10 than strong opioid should be used.

They wrote it for cancer patients but it is a great guideline for chronic pain.

WHO | WHO's cancer pain ladder for adults

[toomuchbaloney]

I wouldn't advocate use of acetominaphen during pregnancy as it has potential to adversely affect fetal brain development.

As well, ibuprofen is not considered safe in various stages of pregnancy and fetal development and is associated with premature closure of the ductus arteriosis.