Pain Management (SHFT and everyday)

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Pain Management (SHFT and everyday)

Post by okiebill » Mon Mar 04, 2013 7:45 pm

I thought I would do a bit of brainstorming on pain management techniques since I see a lot of folks with suture kits but very little in the way of pain management.

ICE! I have been told that Ice will numb skin enough to suture, there are also some commercially available cold sprays that may be a better kit option.
http://www.wisegeek.com/what-is-freeze-spray.htm

Clove oil works on toothaches

A technique that has worked for me involves any topical pain / sunburn gel w/ Lidocaine and a 4"x4" Tegaderm or smaller.
--Apply topical pain gel / cream generously (heap it on)
--Cover area of gel / cream with tegaderm and keep covered for 20-30 minutes
--Remove Tegaderm, clean area and test the numb ( last one I did lasted about 30 minutes)

** WARNING** Do not use this technique on large surface areas as Lidocaine toxicity is a real threat as you increase the covered area and the time covered. I recently read a story where two girls covered both of there legs in Lidocaine gel and plastic wrap to avoid the pain of laser hair removal. Both of the girls died...

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Re: Pain Management (SHFT and everyday)

Post by Dogan » Mon Mar 04, 2013 9:44 pm

I vote for Piper methysticum solution for systemic pain management - easy to process (chew the roots or grind and mix with water), effective (if it's good, your tongue starts going numb before you can swallow it) and it's legal nation wide, despite being a mild narcotic IIRC. Plus it's easy to grow, at least in tropical and subtropical areas, and does not have the stigma attached that marijuana has in the US. Nor as distinctive of a plant structure.
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Re: Pain Management (SHFT and everyday)

Post by angelofwar » Mon Mar 04, 2013 10:24 pm

"The trick, William Potter, is not minding that it hurts"
"The trick, William Potter, is not minding that it hurts..."
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Re: Pain Management (SHFT and everyday)

Post by Purple_Mutant » Tue Mar 05, 2013 8:11 am

Dogan wrote:I vote for Piper methysticum solution for systemic pain management - easy to process (chew the roots or grind and mix with water), effective (if it's good, your tongue starts going numb before you can swallow it) and it's legal nation wide, despite being a mild narcotic IIRC. Plus it's easy to grow, at least in tropical and subtropical areas, and does not have the stigma attached that marijuana has in the US. Nor as distinctive of a plant structure.
Kava (Piper Methysticum) is good stuff. Orally it numbs things up nicely. It's also a fantastic muscle relaxer. As a muscle relaxer I like smoking it. I like using kava extracts for that. Smear it on a cigarette paper and roll up some tobacco or herbal smoking blend. I also like adding it to my hookah. Iamshaman sells kava extracts as well as capsules and powder.

http://www.iamshaman.com/eshop/10Browse ... ava%20Kava

Nowadays I prefer to make own kava extracts from kava powder via soxhlet extraction with acetone as the solvent.

If you decide to try kava, DO YOUR RESEARCH!! It's pretty safe stuff, but as with all herbal remedies, it's best to do plenty of research before trying. If you plan on putting any in your BOB or FAK, make sure you try it out BEFORE the PAW. The PAW is not the time you want to find out kava doesn't agree with you.

Also, keep in mind that kava is illegal in some countries. So make sure to look up your local laws
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Re: Pain Management (SHFT and everyday)

Post by Purple_Mutant » Tue Mar 05, 2013 8:25 am

One I like for more serious pain is Kratom (Mitragyna speciosa). It's a plant from southeast Asia. It's pretty fantastic stuff when ibuprofen wont cut it and the docs are being stingy with the opiates. I was introduced to kratom when I had a nasty sinus infection that was bad enough that I was in tears in the waiting room at the clinic. The most the doc would give me for pain was 600mg motrin, which didn't do much. Someone gave me some kratom resin to try. It tasted like crap but it worked wonders. Took the pain away without making me high. As far as I know kratom is the strongest pain killer available in the US without a prescription.

If you decide to try kratom, DO YOUR RESEARCH!! When it comes to herbal remedies, it's best to do plenty of research before trying. If you plan on putting any in your BOB or FAK, make sure you try it out BEFORE the PAW. The PAW is not the time you want to find out Kratom doesn't agree with you. Kratom should be treated with the same respect you would give an opiate. It can be addictive as I found out first hand. I had some left over kratom resin from the sinus infection and decided to try smoking it, bad idea. I found my self reaching for my bong a little too much and stopped before I developed a serious addiction. Nowadays I will only use kratom for serious pain relief. Also, in an emergency/PAW situation DO NOT give kratom to anyone who hasn't tried it before. If they have a nasty reaction, you may not be able to get to a hospital. Please don't be stupid. Kratom is currently legal. All it takes is a few cases of stupid to end up in the news for kratom to be banned. I would hate to see such an effective non prescription pain killer be made unavailable.

Kratom can be purchased from iamshaman

http://www.iamshaman.com/eshop/10Browse ... ory=Kratom
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Re: Pain Management (SHFT and everyday)

Post by Browning 35 » Tue Mar 05, 2013 8:55 am

If it's in a specific area (broken bone that you're trying to reset, stitching it up, GSW etc) you could try lidocaine.

I broke my finger once at work and I didn't want to report it and until I could get to a doctor my old partner on the ambulance gave me a digi-block in upper palm of my hand midline with the finger. Lasted for a few hours and then we did it again. I hadn't seen it done before and it was interesting to watch. Finally got to the doctor after I got off-duty and they burned a hole through my fingernail to relieve the pressure.
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Re: Pain Management (SHFT and everyday)

Post by okiebill » Tue Mar 05, 2013 7:18 pm

Browning 35 wrote:If it's in a specific area (broken bone that you're trying to reset, stitching it up, GSW etc) you could try lidocaine.

I broke my finger once at work and I didn't want to report it and until I could get to a doctor my old partner on the ambulance gave me a digi-block in upper palm of my hand midline with the finger. Lasted for a few hours and then we did it again. I hadn't seen it done before and it was interesting to watch. Finally got to the doctor after I got off-duty and they burned a hole through my fingernail to relieve the pressure.

Injectable Lidocaine is tricky to get for the average person... Get the training to use it and make friends with your doctor or a friendly Paramedic...lol:-)
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Re: Pain Management (SHFT and everyday)

Post by Browning 35 » Tue Mar 05, 2013 7:25 pm

okiebill wrote:
Browning 35 wrote:If it's in a specific area (broken bone that you're trying to reset, stitching it up, GSW etc) you could try lidocaine.

I broke my finger once at work and I didn't want to report it and until I could get to a doctor my old partner on the ambulance gave me a digi-block in upper palm of my hand midline with the finger. Lasted for a few hours and then we did it again. I hadn't seen it done before and it was interesting to watch. Finally got to the doctor after I got off-duty and they burned a hole through my fingernail to relieve the pressure.

Injectable Lidocaine is tricky to get for the average person... Get the training to use it and make friends with your doctor or a friendly Paramedic...lol:-)
[img]
You can actually buy it online, but knowing what you're doing is a whole other story.

First rule of medicine is do no harm. This is more of an idea for people who already have medical training and who are into having every last detail nailed down.
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Re: Pain Management (SHFT and everyday)

Post by Doctorr Fabulous » Tue Mar 05, 2013 7:28 pm

For smaller pains, or when you have nothing else, distraction. Smoke a cig (if safe) or chew gum. Obviously this won't help anything huge and is not safe for all patients/scenarios.
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Re: Pain Management (SHFT and everyday)

Post by Dogan » Tue Mar 05, 2013 7:30 pm

Browning 35 wrote:First rule of medicine is do no harm.
This is why I don't have a TQ in my FAK: I do not (yet) have the expertise to know what is or is not life threatening, and if someone were to lose a limb due to my incompetence and a superficial wound I would never forgive myself, not to mention the legal ramifications which might result. I carry what I am comfortable using on myself and others.

Please note, I do have first aid and CPR courses in my future, possibly an EMT course. This is not a matter of ignorance or apathy, but rather timing.

Doc: Also, pain distraction. Not saying break someone's finger, but having a subject gently hyperextend their own joint or press on their own pain pressurepoint can do wonders. As can TENS units, but I'll let someone more knowledgeable explain those.
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Re: Pain Management (SHFT and everyday)

Post by Browning 35 » Wed Mar 06, 2013 8:06 am

Dogan wrote:
Browning 35 wrote:First rule of medicine is do no harm.
This is why I don't have a TQ in my FAK: I do not (yet) have the expertise to know what is or is not life threatening, and if someone were to lose a limb due to my incompetence and a superficial wound I would never forgive myself, not to mention the legal ramifications which might result. I carry what I am comfortable using on myself and others.
It's actually pretty easy to recognize significant bleeding that could possibly require a tourniquet.

It looks like This and This.

I've managed to get arterial bleeding stopped without them before (generally the kind that starts spurting with the extension of the arm or leg), but then again my bandages on such bleeds are pretty tight and our transport times to the closest major trauma center are less that 20 mins going code.

OT : You can also buy Celebrex and Ultram online using those online prescription consultations. A friends wife has fiber myalgia and she uses those to supplement her opioid pain relievers. They're in somewhat of a middle class by themselves, better than ibuprofen but not quite as good hydrocodone and other narcotic pain relievers.
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Evan the Diplomat wrote:Why do you want to shoot penguins? What did they ever do to you?
It's that smug, superior attitude of theirs, strutting around in their fancy outfits like they're better than everyone else. Yeah, burn in hell, you snobbish bird bastards.

And don't get me started on pandas!

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Re: Pain Management (SHFT and everyday)

Post by BoonDoc » Wed Mar 06, 2013 5:10 pm

Tylenol 1000mg with ibuprofen 400mg combined works just as well as a few milligrams of morphine.

Here in Ireland you can get both of those with codeine over the counter. They pack a good wallap.

A better option will be diclofenac 75mg with the Tylenol 1gm. I have used this last option for severe pain and went from a fetal position to being able to walk around and continue teaching.

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Re: Pain Management (SHFT and everyday)

Post by Dogan » Wed Mar 06, 2013 5:24 pm

BoonDoc wrote:I have used this last option for severe pain and went from a fetal position to being able to walk around and continue teaching.
An important thing which you just reminded me of: Pain can be good.

If you perform an act, and it causes you pain either immediately or in a delayed manner, you learn not to do it, or to do it with less intensity. This prevents further damage to your physiology. However, if you medicate to get rid of the pain then continue as normal, you can cause horrible damage.
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Re: Pain Management (SHFT and everyday)

Post by medic photog » Wed Mar 06, 2013 7:29 pm

My OTC pain med of choice is ALEVE LIQUID GELS. As for prescribed, I go for Vicodin and add SOMA, a muscle relaxant and keep some FENTANYL around just in case and for SHTF issues. I keep a 2% LIDOCAINE vial in my suture/staple kit. Yes, I am one of those friendly paramedics, but since I'm also on the USAR Task Force I have some additional training I can't use on a daily basis, suturing, other invasive techniques, as a Medical Specialist. That title puts me somewhere between a paramedic and a PA when the team is mobilized.

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Re: Pain Management (SHFT and everyday)

Post by CrossCut » Mon Mar 18, 2013 6:55 am

First post. For local anesthesia, one option is to make your own. Amazon sells all the supplies, it's a fairly simple process, and the ingredients to make more can sit on your shelf for many years. modernsurvivalonline.com/guest-post-how-to-make-injectable-lidocaine-hcl/

You should do your own research on it of course, but I can attest that it works.

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Re: Pain Management (SHFT and everyday)

Post by Hobbit » Mon Mar 18, 2013 12:56 pm

Be grateful that you live somewhere where pain relief during sutures is a given. That isn't the case everywhere, and I'm talking 1st world countries, not 3rd world. Some friends of mine were in a car accident in Italy a couple of months ago, and learned the hard way that they don't use lidocaine while suturing; not even ice. They just use a whole bunch of big burly orderlies to hold you still. If you are under the age of 10, you might get come cookies afterward, though.

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Re: Pain Management (SHFT and everyday)

Post by tac57 » Thu Oct 10, 2013 10:57 pm

Fyi, compounding (making) your own Lidocaine or any other medication is a very bad idea. Strict aseptic technique is required to compound parenteral meds - you need pharmacy training and a biosafety cabinet.

Not that Lidocaine or any other local anesthetic is hard to get (hint - visit canada; its in napra schedule 2. Google is your friend here and if you search you will find the results interesting...)

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Re: Pain Management (SHFT and everyday)

Post by Doctorr Fabulous » Thu Oct 10, 2013 11:30 pm

tac57 wrote:Fyi, compounding (making) your own Lidocaine or any other medication is a very bad idea. Strict aseptic technique is required to compound parenteral meds - you need pharmacy training and a biosafety cabinet.

Not that Lidocaine or any other local anesthetic is hard to get (hint - visit canada; its in napra schedule 2. Google is your friend here and if you search you will find the results interesting...)
Smuggling controlled substances across the border is a bad idea. There are easier ways to get a bored government employee to stick his hand up your ass.
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Re: Pain Management (SHFT and everyday)

Post by tac57 » Fri Oct 11, 2013 10:13 am

Fyi lido is a local anesthetic not a controlled substance.

Sodium channel blocker is moa of local anesthetic.

Opiate receptor agonist is mechanism of opiate pain meds...

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Re: Pain Management (SHFT and everyday)

Post by tac57 » Fri Oct 11, 2013 10:13 am

Although i live in Canada, so its nice.

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Re: Pain Management (SHFT and everyday)

Post by taipan821 » Wed Oct 16, 2013 10:28 pm

not so much for everyday, but for a SHTF situation i would use possibly the oldest pain relief...get them drunk
in the days of sail when a sailor had to have an amputation they gave them rum. the other use of alcohol (spirits mainly)
is that you can use them to clean a wound
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Re: Pain Management (SHFT and everyday)

Post by DannusMaximus » Thu Oct 17, 2013 8:04 am

taipan821 wrote:not so much for everyday, but for a SHTF situation i would use possibly the oldest pain relief...get them drunk
I thought I read somewhere that alcohol acts as a mild blood thinner. That could be completely bum scoop, but if true it could potentially complicate trauma care. Anybody know if there is truth to this?

My first thought was smoke a joint. Small amounts of MJ are de facto legal pretty much anywhere in the U.S. at this point, it numbs a person up pretty well and also acts as a distractor. I'm neither advocating for this or preaching against it, just making an observation.

I've had a few minor medical procedures in the past couple of years (outpatient foot surgery, fairly substantial laceration on my leg that needed sutured, etc.) and the amount of prescription pain killers prescribed was incredible overkill. Like enough to take 6 pills a day (loritabs or the generic equivalent) for 10 days and still have some leftovers. I used maybe a 1/2 days worth in each case and just kept the rest. That's given me a decent stockpile of pain relief drugs, at least enough to keep a person from eating a bullet if they get a nasty injury and it takes a few days to get definitive medical care in an emergency situation.
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Re: Pain Management (SHFT and everyday)

Post by Doctorr Fabulous » Thu Oct 17, 2013 8:32 am

DannusMaximus wrote:
taipan821 wrote:not so much for everyday, but for a SHTF situation i would use possibly the oldest pain relief...get them drunk
I thought I read somewhere that alcohol acts as a mild blood thinner. That could be completely bum scoop, but if true it could potentially complicate trauma care. Anybody know if there is truth to this?
Alcohol has several effects that complicate trauma care, if I recall my training. Vasodialator, something of an anticoagulant, and it dehydrates.
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Re: Pain Management (SHFT and everyday)

Post by DannusMaximus » Thu Oct 17, 2013 8:36 am

Doctorr Fabulous wrote:
DannusMaximus wrote:
taipan821 wrote:not so much for everyday, but for a SHTF situation i would use possibly the oldest pain relief...get them drunk
I thought I read somewhere that alcohol acts as a mild blood thinner. That could be completely bum scoop, but if true it could potentially complicate trauma care. Anybody know if there is truth to this?
Alcohol has several effects that complicate trauma care, if I recall my training. Vasodialator, something of an anticoagulant, and it dehydrates.
Good recall on the vasodilation effect. I tend to think of that more in relation to hypothermia (booze makes you feel warm, but actually causes more rapid heat loss), but it would definitely cause additional issues with trauma.
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