We in the LAS will soon have a new drug to play with.
Morphine is an excellent painkiller, in our case it will be given through an injection straight into a vein causing nearly instant relief of pain. It's a pretty safe drug in that few people are allergic to it, and even if we make a huge mistake and overdose someone, it is really easy to reverse using another drug (Narcan) that we have been using for years.
But all is not perfect with this drug. It's potency, and the ability to get people 'high' means that it is a 'Controlled Drug', with whole books of legislation covering it. It should be stored in a double locked wall safe, every usage must be well recorded and every use should be witnessed by two professionals.
This is a bit of a problem for the ambulance service. While we have double locked wall safes on station to keep the stock on, the ambulances are a bit short on these. Instead we have come up with a plan, that for reasons that will are obvious, I won't be mentioning here.
Why won't I mention where we are keeping it? Let me put it this way, junkies love morphine, especially the nice pure, safe stuff that we will be carrying. Junkies also have a habit of turning to crime to get their 'fix'. We don't want junkies stealing our Morphine, if only because it will mean filling in a tree-load of paperwork.
So the Morphine is safely padlocked and hidden away. Although to be honest, the security is all in the hiding, rather than in the padlock…
Even though Morphine is a paramedic only drug, meaning us poor lowly EMTs can't give it, we all have to undergo the additional training. The reasoning behind this isn't because we can't trust the Paramedics not to muck it all up and give the wrong dose, but because we have to sign our name to a bit of paperwork every time Morphine is given to say that the patient got the right dose, and that our Paramedic crewmate isn't shooting up in the carpark/selling it on the street.
So we have all had a look at the drug information sheet, we had a laugh at one of the contraindications (reasons when not to give the drug) as being described as 'rare as rocking horse shite'. You wouldn't get that in a nursing memo.
The issue I have with the use of this drug is in its dosage and administration. For the medical people out there, the dosage is 2.5mg over two minutes, repeated every 5 minutes (I may have to amend this later, I've left the information chart at home). For the non-medical people, this is a dosage that seems almost homeopathic in nature. It is a tiny dose. I'm considering all the times in hospital we'd give 8mg immediately, and another 2mg to 'top up'. While I understand that too much can cause you to stop breathing, we do have the 'antidote' sitting right next to it.
While I understand the concerns of our Clinical director, I hope that this will get reviewed at some point in the near future.
What has been done right is that the drug comes in pre-filled syringes. We won't have to faff around with needles, bottles of water, and shaking up bottles of powder. Instead it is a simple process to pull out a syringe, flip off the top and give the patient some pain relief.
So we are moving forward with our pain relief treatments, which can only be a good thing.
Although I don't think we will be getting paid any more for our new skills…