I should have mentioned that we also were shown how to use Entonox (it couldn't be much simpler!) but that was only for use on base; it wasn't a practical option to carry it in the field.
I think that inserting an IV needle into a vein on a moving vessel would be pretty difficult! I've had some pretty bad experiences in a nice stable hospital ward (usually when a junior doctor didn't get out of the way and let the nurse do it!)
I think that fitting it into the field stores you carry in addition to all the scientific instruments might have something to do with it..?
No, it's because a two-person field party emplaced by air has pretty stringent weight restrictions. A cylinder of Entonox that might only last for an hour or so isn't in competition with a few grams of morphine that will provide pain relief for days. I'm afraid my skills in putting needles into people stops at sticking them into the upper, outer quarter of the buttock!
Entonox, it was what the ambulance crew gave me after a riding accident did for one of my knees, once on the gas I didn't mind about the pain too much, then into hospital they gave me some form of morphine and I really didn't care at all at all, that was in 1999.
It's not for everyone, though. I had heavy opioid pain relief after orthopaedic surgery, and couldn't keep anything - not even water - down for two days, until they decided that I could manage without. For the next few days my day was measured by the interval between doses of co-codamol.Re morphine, my wife was given some once while in the hospital, it seems to generate an immediate ecstatic smile.
We had it on the boat, our doctor insisted so we thought why not.
She was once hit by a very severe migraine attack, even all the pills she usually takes were useless; fortunately we were in port, after two days of severe pain, one night I just stopped her while she was sleep walking in the boat, loosely looking for the pharmacy chest while saying: morphine, morphine.
We were in Coruna, we went at 0100 AM to the local hospital, they put her with an IV with something strong, though not morphine.
The story still makes us laugh, even the children "Mom remember when you were deambulating in the dark, half asleep, saying morphine morphine"
Nubain. It could only be given IV whereas morphine can be given IM if you can't get IV access. Entonox can be quite successful in managing pain in some people, quite useless in others! We also have had IV paracetamol which, in some cases, can be more effective than morphine without the side effects. I tend to use a "pain ladder" which goes something like oral pr like paracetamol or ibuprofen, entonox, IV paracetamol then morphine. It does make me smile when I ask a patient what their pain score is from 1 to 10 and they reply 10 while sitting quite comfortably and texting on their phone!
Yes, but your vehicle wasn't moving and rotating in three dimensions with amplitudes measured in metres - at least, if it was I want to avoid driving where you are ??
Same here, as you say, they are guidelines, not hard rules. I explained to my Doc that I would be away sailing for the best part of five months and he had no problem with two month scripts. He did have a problem issuing more than two months but was ok with me repeat scripting early so about January I started reordering every month to build up a stock for five months.
When you get into what you can actually perform by way of medical intervention on yourself or crew it's rather sobering. Not much. For anything broken or enduring pain you need to be ashore. Fast. So apart from the obvious slings and bandages, steristrips, antiseptic creams, broad spectrum antibiotics, you are not going to need to persuade a medic to write you a scrip. Existing conditions excepted: get a private scrip and get pharmacists to bid for the business. In the UK ASDA is reliable.
