Had a long day I sort of need to vent and get some opinions at the same time. I fairly new to working in the emergency spectrum of things and I know about pain thresh holds but something really ticked me off today! I have recently been working observer shifts with paramedic's and working in a resonably busy ED.
Today I started my shift with the paramedic's and the first call was to a 65 year old femal who had suffered a fall. when we got to her she was calm, orientated, and had no visable signs of shock. She stated that she had fallen over and given her right knee a bit of a "bump" and she had also hurt her right wrist and elbow in the fall. She stated that her pain was about a 2 at rest and went up to a 4 on movment. She had no significant history and we gave her 3 mls of methoxyflurane whilst we transported her. The whole time she was quite calm and rarley used the wistle. Found out later that day that she had # her head of her radius and # her patella (it was in 3 pieces)
The next job was a 27 year old who had an obvious # to his 2nd proximal phlange, it happens when you stick it in a pitt bulls mouth. His history was IV drug use, tattoos, ear rings (4 of them) but he didn't like needles?? By the time we got to him he already had 75 mg of pethadine on board, and by the time we got him to the hospital he had another 15 mg of morphine on board in 2.5 mg doses and yet still complained of pain.
Am I being a bit harsh here or is this bloke a bit of a sook? And is this an every day thing for you guy's?
i just wanted to put in my 2cents worth. i agree with dixielee. also i have noticed that the older generations( over 60) are more stoic. the younger generations have been raised ( for the most part) to think that they are entitled to never feel pain. they are more prone to whine and complain( we call 'em bmw-b**ch,moan,whine) about the least hurt and expect immediate relief for said pain. the older generation has been around when you didn't take something just because you hurt a little and aspirin was a major drug. they(usually) are more appreciative of any help. now that said there are exceptions to every rule and i do have my younger people who never ask for pain meds even if they are in agony and i just buried one of my oldest drug seekers( he was 80 and had killed his kidneys and liver with narcotics and booze).
I constantly try to remind myself that different people have different pain thresholds. Mine is (apparently) enormously high so I have been known to "slip" and not be impressed by another's pain.
I do have a problem with the patient that is snoring so loudly that I can hear them at the nurses desk that will then tell me their pain is still 10/10 & they need more medications, only to find them snoring again when I return.
I do sometimes think age can be a factor as well. The old lady with a broken hip may do fine with tylenol. A young person who has never really experienced things like childbirth, broken bones, smashed fingers, etc. is shocked at how much something hurts! I do think as well, people do have different pain tolerances built in. Some people feel better yelling with pain, others whimper, all human.
Thank you for posting this as it does make a lot of sense.
I suspect that for the younger person, fear of the unknown combined
with the lack of experience with painful life experiences has a lot to do
with lower pain tolerance. I just never thought of it that way before.
I remember a lady drove herself to and walked in the ER nice and calm, with a bit of a limp c/o hip pain. She walked to Xray, and came back on a stretcher yes she had a Frx hip.
But we more of those with severe inability to handle, or cope adequately even with the seemingly smallest of pains. real wimps
Working in rehab has given me a new insight to the pain issue. In general I have found older people more able to cope with pain. We have a 92 year old lady with a L hip ORIF who says she feels SOME discomfort and tylenol will be fine and a 19 yr old with a broken ankle who cannot survive without at LEAST Roxi on board.
I have also found that in general (no offense meant here) that women are much better able to cope with pain than men. The men with the exact same fx as the women get medicated MUCH more frequently for pain. I have often said that if men had to go through childbirth, the human race would die out... my work has just reinforced that lol
One observation I haven't seen here yet is that slower nerve conduction occurs with aging which can lead to diminshed pain perception.
It's possible that some elderly people don't realize how injured they are because their body isn't giving them the same signals it would if they were younger...of course, I know some pretty tough grannies, so it could just depend on the individual. :)
ERNURSE4MS
80 Posts
i just wanted to put in my 2cents worth. i agree with dixielee. also i have noticed that the older generations( over 60) are more stoic. the younger generations have been raised ( for the most part) to think that they are entitled to never feel pain. they are more prone to whine and complain( we call 'em bmw-b**ch,moan,whine) about the least hurt and expect immediate relief for said pain. the older generation has been around when you didn't take something just because you hurt a little and aspirin was a major drug. they(usually) are more appreciative of any help. now that said there are exceptions to every rule and i do have my younger people who never ask for pain meds even if they are in agony and i just buried one of my oldest drug seekers( he was 80 and had killed his kidneys and liver with narcotics and booze).