Filtered By:
Drug: Morphine
This page shows you your search results in order of date.
Order by Relevance | Date
Total 117 results found since Jan 2013.
A man in his 50s with chest pain
Sent by anonymous, written by Pendell MeyersA man in his 50s with no prior known medical history presented to the Emergency Department with severe intermittent chest pain. He had episodes of chest pain off and on all night, until about 1 hour prior to arrival when the pain became constant, crushing, 10/10 chest pain that radiated to both arms. He denied any lightheadedness, shortness of breath, vomiting, or abdominal pain. Vitals were within normal limits.Here is his triage ECG at 0343:What do you think?Meyers interpretation: Diagnostic of LAD OMI, with hyperacute T waves in a large LAD distribution including precord...
Source: Dr. Smith's ECG Blog - March 9, 2023 Category: Cardiology Authors: Pendell Source Type: blogs
Undisclosed Conflicts of Interest by Physicians Creating the CDC Opioid Prescribing Guidelines: Bad Faith or Incompetence?
We described above how changes in opioid policy aimed at reducing Washington State’s Medicaid and Workers Compensation costs contributed to an increase in methadone deaths between 2003 and late 2014 (23-25). Focusing on similar cost reductions, the Centers for Medicar e and Medicaid Services (CMS) proposed rules for 2019 including several directives intended to reduce " Opioid Overutilization, ” including adoption of the “90 morphine milligram equivalent (MME) threshold cited by the 2016 CDC Opioid Guideline (147, 148). Simply put, reduced prescribing reduces costs for prescribed medications.Chou received research fu...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 12, 2022 Category: Palliative Care Tags: health policy judy kollas opioids research schechtman Source Type: blogs
Weekly Australian Health IT Links – 05 September, 2022.
Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.General Comment-----There seems to be a good bit going on this week so lots to browse!The trial of AI in aged care was quite amusing in a sad sort of way ….-----https://medicalrepublic.com.au/whos-to-blame-when-the-software-gets-it-wrong/7586330 August 2022Who ’s to blame when the software gets it wrong?MedicolegalTechnologyByPursuitClinical deci...
Source: Australian Health Information Technology - September 5, 2022 Category: Information Technology Authors: Dr David G More MB PhD Source Type: blogs
A man in his 60s with chest pain. Cardiologist refuses to take to the lab. Obvious STEMI, even with criteria. Yet final diagnosis " NSTEMI " . This happens far too often.
Submitted by Anonymous MD, edits by MeyersA man in his 60s with past medical history of multiple sclerosis and hypertension was brought in by EMS from home for chest pain thatstarted acutely just prior to arrival. He rated the pain at 9/10, describes as pressure, radiates towards the left arm with associated shortness of breath, diaphoresis and had one episode of emesis. He did not have a prior history of CAD or other cardiac disease. His pain improved to 6/10 after EMS gave him 3 sprays of sublingual nitroglycerin and 324 mg of aspirin. Prehospital ECGs:What do you think?Both ECGs are diagnostic of acute LAD OMI...
Source: Dr. Smith's ECG Blog - April 15, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
A man in his 50s with acute chest pain and history of prior MI
Written by Pendell MeyersA man in his 50s with prior history of anterior MI with LAD stent presented with acute chest pain similar but more intense than his last MI. He presented around midnight with pain that had started around 9pm the night before. He had taken NTG at home with no improvement, and immediately received morphine on arrival at the ED for severe chest pain (a very bad idea if your accuracy for finding OMI on ECG is low, since ongoing pain will be your last chance to identify those with ongoing untreated OMI).Here is his triage ECG at 0012:What do you think? What is the differential of this ECG?There is sinus...
Source: Dr. Smith's ECG Blog - April 13, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Opioid Equianalgesic Tables are Broken
by Drew Rosielle (@drosielle)I am proposing we do away with equianalgesic table (EAT) as a tool to inform clinical decisions about opioid rotations/conversions. Fundamentally, EATs create too many problems, and there are simpler and safer ways to teach clinicians how to convert between different opioids.Part 1: New Data Can ' t Fix the EATA couple HPM fellows every year ask me which table do I prefer to use —the old EAT or the new one? By the old one, they refer to the table most of us used or were at least deeply familiar with for the last 10-20 years. By the new one, they mean the one created by Dr. Mary Lynn McPherson...
Source: Pallimed: A Hospice and Palliative Medicine Blog - March 21, 2022 Category: Palliative Care Tags: opioid pain rosielle Source Type: blogs
A man in his 60s woken from sleep by epigastric pain. Would you have been able to correctly diagnose him?
Written by Pendell MeyersA man in his mid 60s with history of CAD and stents experienced sudden onset epigastric abdominal pain radiating up into his chest at home, waking him from sleep. He called EMS who brought him to the ED. He had active chest pain at the time of triage at 0137 at night, with this triage ECG:I sent this ECG, without any text at all, to Dr. Smith, and he replied: " LAD OMI with low certainty. V3 is the one that is convincing. " After his response I sent him the baseline ECG (below), still with no context at all except that this was his prior ECG:Dr. Smith replied: " Now high certainty. By the way,...
Source: Dr. Smith's ECG Blog - October 5, 2021 Category: Cardiology Authors: Pendell Source Type: blogs
Roger Chou ’s Undisclosed Conflicts of Interest: How the CDC’s 2016 Guideline for Prescribing Opioids for Chronic Pain Lost Its Clinical and Professional Integrity
by Chad D. Kollas MD, Terri A. Lewis PhD, Beverly Schechtman and Carrie Judy“I ' m present. Uh … I do have a conflict. I receive funding to conduct reviews on opioids, and I ' ll be recusing myself after the um, director ' s, uh, um, um, uh … update.”- Dr. Roger Chou, Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) Board of Scientific Counselors (BSC) Meeting Friday, July 16, 2021.IntroductionFor those familiar with the controversial relationship between the anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP, recently renamed, He...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 17, 2021 Category: Palliative Care Tags: CDC judy kollas lewis opioid pain schechtman Source Type: blogs
Roger Chou s Undisclosed Conflicts of Interest: How the CDCs 2016 Guideline for Prescribing Opioids for Chronic Pain Lost Its Clinical and Professional Integrity
by Chad D. Kollas MD, Terri A. Lewis PhD, Beverly Schechtman and Carrie JudyI ' m present. Uh I do have a conflict. I receive funding to conduct reviews on opioids, and I ' ll be recusing myself after the um, director ' s, uh, um, um, uh update.- Dr. Roger Chou, Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) Board of Scientific Counselors (BSC) Meeting Friday, July 16, 2021.IntroductionFor those familiar with the controversial relationship between the anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP, recently renamed, Health Pro...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 17, 2021 Category: Palliative Care Tags: CDC judy kollas lewis opioid pain schechtman Source Type: blogs
If Lawmakers Really Want to “Follow the Science” They Will Repeal Codified Opioid Guidelines
This study documents a relationship between opioid prescribing and opioid overdose in a large, national, prospective cohort of individuals receiving opioid therapy for a variety of medical conditions. The risk of opioid overdose should continue to be evaluated relative to the need to reduce pain and suffering and be considered along with other risk factors.University of Alabama Professor of Medicine Stefan Kerteszpointed out thatfollow up research led by Bohnert found the median overdose dosage was 60 MMEs and 86 percent occurred under 90 MMEs. Yet he cautioned policymakers:Reliance on a simple binary dose metric is an ext...
Source: Cato-at-liberty - May 24, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
PROP s Disproportionate Influence on U.S. Opioid Policy: The Harms of Intended Consequences
ConclusionDespite being turned back from an effort to bluntly reduce opioid prescribing by the FDA in 2013 based on a lack of scientific evidence for its position (17,18), PROP has had a disproportionate effect on opioid policy in the Untied States for almost a decade. PROP found a willing federal regulatory partner in the CDC, and while PROP may not have secretly written the 2016 CDC Pain Guidelines (75), they certainly enjoyed disproportionate representation on CDCs review panels and Core Expert Group (23-25) in a process that lacked transparency (22, 23, 26, 27). When the CDC admitted that its Pain Guideline had been...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 3, 2021 Category: Palliative Care Tags: CDC health policy kollas opioids pain prop Source Type: blogs
PROP ’s Disproportionate Influence on U.S. Opioid Policy: The Harms of Intended Consequences
ConclusionDespite being turned back from an effort to bluntly reduce opioid prescribing by the FDA in 2013 based on a lack of scientific evidence for its position (17,18), PROP has had a disproportionate effect on opioid policy in the Untied States for almost a decade. PROP found a willing federal regulatory partner in the CDC, and while PROP may not have “secretly written” the 2016 CDC Pain Guidelines (75), they certainly enjoyed disproportionate representation on CDC’s review panels and Core Expert Group (23-25) in a process that lacked transparency (22, 23, 26, 27). When the CDC admitted that its Pain Guideline ha...
Source: Pallimed: A Hospice and Palliative Medicine Blog - May 3, 2021 Category: Palliative Care Tags: CDC health policy kollas opioids pain prop Source Type: blogs
Merging the wisdom of pain medicine and addiction medicine to optimize outcomes
Family lore recalls that my grandfather, succumbing to stomach cancer in the mid-1960s, “died addicted to morphine.” Decades before the AIDS crisis sparked the hospice and palliative care movements, the confluences of pain, dependence, and addiction were confused and regrettably moralized. Since then, the science has excelled, but our clinical understanding of how pain and […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Source: Kevin, M.D. - Medical Weblog - January 16, 2021 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/julie-craig" rel="tag" > Julie Craig, MD < /a > < /span > Tags: Meds Pain Management Source Type: blogs
Pain and Circumstance
My wife Diane and I visited our friend Mary in the hospital on Friday. Mary had just had her “knee replaced” — which is a rather spectacular modern procedure, unimagined not too many years ago. Another modern, commonplace aspect of this kind of surgery was being “enjoyed” by Mary – her morphine-on-demand dispenser! Her machine delivered a small dose of morphine intravenously every time she thought she needed it, with the proviso that no request would be granted until 6 minutes had passed since the last slug.
Mary’s setup, combined with Memorial Day, reminded me of a landmark stud...
Source: On the Brain by Dr. Michael Merzenich, Ph.D. - January 1, 2021 Category: Neuroscience Authors: Dr. Merzenich Tags: Aging and the Brain Brain Fitness BrainHQ Source Type: blogs
Medical aid in dying is not assisted suicide PODCAST
“To help the reader understand the issues better, I would like to relate some stories. A friend of mine was dying of pancreatic cancer. He had an implantable morphine pump and was on both hospice and palliative care. Still, he found that his suffering was unbearable and wanted to die sooner. Doctors told him that […]Find jobs at Careers by KevinMD.com. Search thousands of physician, PA, NP, and CRNA jobs now. Learn more.
Source: Kevin, M.D. - Medical Weblog - November 9, 2020 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/blog/post-author/the-podcast-by-kevinmd" rel="tag" > The Podcast by KevinMD < /a > < /span > Tags: Podcast Palliative Care Source Type: blogs
