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Hi, it might be worth checking your status in law if you prescribe,

apparently you don't get days out and sky TV in their prisons.

Just a thought

Tony

>From: " Sharpe, Ian [AT] " <Ian.Sharpe@...>

>Reply-

><Remotesupportmedics >

>Subject: FW: opiad analgesia

>Date: Sun, 29 Oct 2006 13:53:54 +0500

>

>Gents anyone help out with Micks question ?

>

>

>

>________________________________

>

>From: Air [mailto:mair63@...]

>Sent: Sunday, October 29, 2006 1:49 PM

>Sharpe, Ian [AT]

>Subject: opiad analgesia

>

>

>

>Hi Ian,

>

>I am currently working with a uxo team out in Libya and have great

>difficulty gaining access to any pain relieving analgesia.They (the

>local doctors) have decided voltarol IM 50mg and or valium will suffice

>until delivered to the hospital.

>

>Not the best solution when we are dealing with munitions.....

>

>The nearest hospital is 80 kms from ambulance exchange point, and we are

>on average about the same distance from the road.

>

>We have no helicopter support out here either.I suppose this is why i

>joined the remote medic fraternity again......any suggestions on how to

>best get passed the bollox of import/export licencing.

>

>Apparently opiods are only allowed in hospitals in Libya!!

>

>hope all is well,chat soon

>

>Mick Air

>

>

>

>

>________________________________

>

>Windows Live Messenger has arrived. Click here to download it for

>free! <http://g.msn.com/8HMBENUK/2755??PS=47575>

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>

>

>

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Ian,

Replied direct.

Regards

On 10/29/06, Sharpe, Ian [AT] <Ian.Sharpe@...> wrote:

>

> Gents anyone help out with Micks question ?

>

>

>

> ________________________________

>

> From: Air [mailto:mair63@...]

> Sent: Sunday, October 29, 2006 1:49 PM

> Sharpe, Ian [AT]

> Subject: opiad analgesia

>

>

>

> Hi Ian,

>

> I am currently working with a uxo team out in Libya and have great

> difficulty gaining access to any pain relieving analgesia.They (the

> local doctors) have decided voltarol IM 50mg and or valium will suffice

> until delivered to the hospital.

>

> Not the best solution when we are dealing with munitions.....

>

> The nearest hospital is 80 kms from ambulance exchange point, and we are

> on average about the same distance from the road.

>

> We have no helicopter support out here either.I suppose this is why i

> joined the remote medic fraternity again......any suggestions on how to

> best get passed the bollox of import/export licencing.

>

> Apparently opiods are only allowed in hospitals in Libya!!

>

> hope all is well,chat soon

>

> Mick Air

>

>

>

>

> ________________________________

>

> Windows Live Messenger has arrived. Click here to download it for

> free! <http://g.msn.com/8HMBENUK/2755??PS=47575>

>

>

>

>

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Thanks J. I passed it on to Mick

opiad analgesia

>

>

>

> Hi Ian,

>

> I am currently working with a uxo team out in Libya and have great

> difficulty gaining access to any pain relieving analgesia.They (the

> local doctors) have decided voltarol IM 50mg and or valium will

suffice

> until delivered to the hospital.

>

> Not the best solution when we are dealing with munitions.....

>

> The nearest hospital is 80 kms from ambulance exchange point, and we

are

> on average about the same distance from the road.

>

> We have no helicopter support out here either.I suppose this is why i

> joined the remote medic fraternity again......any suggestions on how

to

> best get passed the bollox of import/export licencing.

>

> Apparently opiods are only allowed in hospitals in Libya!!

>

> hope all is well,chat soon

>

> Mick Air

>

>

>

>

> ________________________________

>

> Windows Live Messenger has arrived. Click here to download it for

> free! <http://g.msn.com/8HMBENUK/2755??PS=47575>

>

>

>

>

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Gents anyone help out with Micks question ?

________________________________

From: Air [mailto:mair63@...]

Sent: Sunday, October 29, 2006 1:49 PM

Sharpe, Ian [AT]

Subject: opiad analgesia

Hi Ian,

I am currently working with a uxo team out in Libya and have great

difficulty gaining access to any pain relieving analgesia.They (the

local doctors) have decided voltarol IM 50mg and or valium will suffice

until delivered to the hospital.

Not the best solution when we are dealing with munitions.....

The nearest hospital is 80 kms from ambulance exchange point, and we are

on average about the same distance from the road.

We have no helicopter support out here either.I suppose this is why i

joined the remote medic fraternity again......any suggestions on how to

best get passed the bollox of import/export licencing.

Apparently opiods are only allowed in hospitals in Libya!!

hope all is well,chat soon

Mick Air

________________________________

Windows Live Messenger has arrived. Click here to download it for

free! <http://g.msn.com/8HMBENUK/2755??PS=47575>

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Ketamine at the right dose could do both jobs

opiad analgesia

Hi Ian,

I am currently working with a uxo team out in Libya and have great

difficulty gaining access to any pain relieving analgesia.They (the

local doctors) have decided voltarol IM 50mg and or valium will suffice

until delivered to the hospital.

Not the best solution when we are dealing with munitions.....

The nearest hospital is 80 kms from ambulance exchange point, and we are

on average about the same distance from the road.

We have no helicopter support out here either.I suppose this is why i

joined the remote medic fraternity again......any suggestions on how to

best get passed the bollox of import/export licencing.

Apparently opiods are only allowed in hospitals in Libya!!

hope all is well,chat soon

Mick Air

________________________________

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Hiya Mick,

Have you thought about Tramadol, its good IM and IV (over a

couple of mins), not perfect but a stand in until you get sorted.

Not sure how the Libyans see Tramadols classification either?

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Ketamine plus midazolam or diazepam to control hallucinations etc as they

wake up

Cheers,

>From: " Ross Boardman " <ross.boardman@...>

>Reply-

>< >

>Subject: RE: FW: opiad analgesia

>Date: Sun, 29 Oct 2006 11:01:11 -0000

>

>Ketamine at the right dose could do both jobs

>

>

>

> opiad analgesia

>

> Hi Ian,

>

> I am currently working with a uxo team out in Libya and have great

> difficulty gaining access to any pain relieving analgesia.They (the

> local doctors) have decided voltarol IM 50mg and or valium will suffice

> until delivered to the hospital.

>

> Not the best solution when we are dealing with munitions.....

>

> The nearest hospital is 80 kms from ambulance exchange point, and we are

> on average about the same distance from the road.

>

> We have no helicopter support out here either.I suppose this is why i

> joined the remote medic fraternity again......any suggestions on how to

> best get passed the bollox of import/export licencing.

>

> Apparently opiods are only allowed in hospitals in Libya!!

>

> hope all is well,chat soon

>

> Mick Air

>

> ________________________________

>

> Recent Activity

> a.. 6New Members

> b.. 2New Files

> Visit Your Group

>

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so thats what happened to Ross!

Tom G

>From: " Baker " <RJGBAKER@...>

>Reply-

>

>Subject: RE: FW: opiad analgesia

>Date: Mon, 30 Oct 2006 04:44:06 +0000

>

>

>Ketamine plus midazolam or diazepam to control hallucinations etc as they

>wake up

>

>Cheers,

>

> >From: " Ross Boardman " <ross.boardman@...>

> >Reply-

> >< >

> >Subject: RE: FW: opiad analgesia

> >Date: Sun, 29 Oct 2006 11:01:11 -0000

> >

> >Ketamine at the right dose could do both jobs

> >

> >

> >

> > opiad analgesia

> >

> > Hi Ian,

> >

> > I am currently working with a uxo team out in Libya and have great

> > difficulty gaining access to any pain relieving analgesia.They (the

> > local doctors) have decided voltarol IM 50mg and or valium will

>suffice

> > until delivered to the hospital.

> >

> > Not the best solution when we are dealing with munitions.....

> >

> > The nearest hospital is 80 kms from ambulance exchange point, and we

>are

> > on average about the same distance from the road.

> >

> > We have no helicopter support out here either.I suppose this is why i

> > joined the remote medic fraternity again......any suggestions on how

>to

> > best get passed the bollox of import/export licencing.

> >

> > Apparently opiods are only allowed in hospitals in Libya!!

> >

> > hope all is well,chat soon

> >

> > Mick Air

> >

> > ________________________________

> >

> > Recent Activity

> > a.. 6New Members

> > b.. 2New Files

> > Visit Your Group

> >

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Whilst in Iraq, the American Medics favoured this NSAID, as it can be

given IV as well for moderate to severe pain. Below is a short

discription. I have used it in a couple of cases, and it showed to be

quite effective. It seemed stronger than Voltaren.

Hope this helps.

http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202318.html

Ketorolac ( kee-toe-ROLE-ak) is used to relieve moderately severe pain,

usually pain that occurs after an operation or other painful procedure.

It belongs to the group of medicines called nonsteroidal anti-

inflammatory drugs (NSAIDs). Ketorolac is not a narcotic and is not

habit-forming. It will not cause physical or mental dependence, as

narcotics can. However, ketorolac is sometimes used together with a

narcotic to provide better pain relief than either medicine used alone.

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Have used ketorolac many times much stronger and faster acting in my opinion

than voltaren great most most of the " muscle " pains and suprising me greatly

very good for severe cases of piles as well and some mouth pain from

swelling and abcesses

Cheers

Tom G

>From: " medicrudy " <medicrudy@...>

>Reply-

>

>Subject: Re: FW: opiad analgesia

>Date: Mon, 30 Oct 2006 12:08:27 -0000

>

>Whilst in Iraq, the American Medics favoured this NSAID, as it can be

>given IV as well for moderate to severe pain. Below is a short

>discription. I have used it in a couple of cases, and it showed to be

>quite effective. It seemed stronger than Voltaren.

>

>Hope this helps.

>

>

>http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202318.html

>

>Ketorolac ( kee-toe-ROLE-ak) is used to relieve moderately severe pain,

>usually pain that occurs after an operation or other painful procedure.

>It belongs to the group of medicines called nonsteroidal anti-

>inflammatory drugs (NSAIDs). Ketorolac is not a narcotic and is not

>habit-forming. It will not cause physical or mental dependence, as

>narcotics can. However, ketorolac is sometimes used together with a

>narcotic to provide better pain relief than either medicine used alone.

>

>

>

>

>

_________________________________________________________________

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I agree, good for renal stones/infections as well. In the old days we used to

mix it (Voodoo/witch-doctor style)with Nubain (when still available) before they

changed the composite (now causes precipitation), thereby using two effective

analgesics not listed as narcotics.

In another African-Arabic country, it was the norm for the doctors to combine

injectable Asprin (Aspegic) with Voltaren 75mg and give it IV...of course, made

me nervous as hell.Once it goes in...no way it comes out! However, the few times

I saw it, it worked okay.

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Ketorolac (brand name in the U.S. is Toradol) is an NSAID that is

commonly used, but probably no more effective than oral ibuprofen in

most cases. It has approximately the same COX 1/COX 2 profile.

When it first came out some years back, it was touted by many as the

end-all in pain management. But in my experience it works poorly with

musculoskeletal pain. I have given tons of it and am generally

unimpressed.

It is outstanding for patients with renal colic - it provides almost

magical pain relief for these people. For anyone else, give 'em 800

mg of ibuprofen and you will have done just as much for them.

LT

medicrudy wrote:

> Whilst in Iraq, the American Medics favoured this NSAID, as it can be

> given IV as well for moderate to severe pain. Below is a short

> discription. I have used it in a couple of cases, and it showed to be

> quite effective. It seemed stronger than Voltaren.

>

> Hope this helps.

>

>

> http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202318.html

>

> Ketorolac ( kee-toe-ROLE-ak) is used to relieve moderately severe pain,

> usually pain that occurs after an operation or other painful procedure.

> It belongs to the group of medicines called nonsteroidal anti-

> inflammatory drugs (NSAIDs). Ketorolac is not a narcotic and is not

> habit-forming. It will not cause physical or mental dependence, as

> narcotics can. However, ketorolac is sometimes used together with a

> narcotic to provide better pain relief than either medicine used alone.

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I have had great experience with it ­ 30mg IV, and I have seen 30 IV/30 IM

at the same time as well. For kidney stones it has been very effective in

my experience, and in several open fractures it brought the pain down

considerably to easily managed levels, I have always been impressed by the

drastic amount of pain relief. Usually it is with males in their mid-20¹s

with musculoskeletal trauma ­ the US Military, especially Special Ops are

really into it. Interesting discussion as I hear quite often of variable

experience.

-

On 10/30/06 9:24 AM, " Larry Torrey " <ltorrey@...> wrote:

>

>

>

>

> Ketorolac (brand name in the U.S. is Toradol) is an NSAID that is

> commonly used, but probably no more effective than oral ibuprofen in

> most cases. It has approximately the same COX 1/COX 2 profile.

>

> When it first came out some years back, it was touted by many as the

> end-all in pain management. But in my experience it works poorly with

> musculoskeletal pain. I have given tons of it and am generally

> unimpressed.

>

> It is outstanding for patients with renal colic - it provides almost

> magical pain relief for these people. For anyone else, give 'em 800

> mg of ibuprofen and you will have done just as much for them.

>

> LT

>

> medicrudy wrote:

>> > Whilst in Iraq, the American Medics favoured this NSAID, as it can be

>> > given IV as well for moderate to severe pain. Below is a short

>> > discription. I have used it in a couple of cases, and it showed to be

>> > quite effective. It seemed stronger than Voltaren.

>> >

>> > Hope this helps.

>> >

>> >

>> > http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202318.html

>> >

>> > Ketorolac ( kee-toe-ROLE-ak) is used to relieve moderately severe pain,

>> > usually pain that occurs after an operation or other painful procedure.

>> > It belongs to the group of medicines called nonsteroidal anti-

>> > inflammatory drugs (NSAIDs). Ketorolac is not a narcotic and is not

>> > habit-forming. It will not cause physical or mental dependence, as

>> > narcotics can. However, ketorolac is sometimes used together with a

>> > narcotic to provide better pain relief than either medicine used alone.

>

>

>

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I agree with everything you wrote, and this is great for renal colic, but the

question asked was for an alternative to narcotics, with quick action

pain-relief in Libya due to country legislation. Another alternative mentioned

before, was Tramadol. Correct me if I am wrong, but shouldn't IV Toradol work

faster than oral Ibuprofen...if used for say renal colic. 800mg Ibuprofen

tablets (the big white dog) is very effective (personal experience) for

musculoskeletal pain....nothing less than 800mg.

Re: Re: FW: opiad analgesia

Ketorolac (brand name in the U.S. is Toradol) is an NSAID that is

commonly used, but probably no more effective than oral ibuprofen in

most cases. It has approximately the same COX 1/COX 2 profile.

When it first came out some years back, it was touted by many as the

end-all in pain management. But in my experience it works poorly with

musculoskeletal pain. I have given tons of it and am generally

unimpressed.

It is outstanding for patients with renal colic - it provides almost

magical pain relief for these people. For anyone else, give 'em 800

mg of ibuprofen and you will have done just as much for them.

LT

medicrudy wrote:

> Whilst in Iraq, the American Medics favoured this NSAID, as it can be

> given IV as well for moderate to severe pain. Below is a short

> discription. I have used it in a couple of cases, and it showed to be

> quite effective. It seemed stronger than Voltaren.

>

> Hope this helps.

>

>

> http://www.nlm. nih.gov/medlinep lus/druginfo/ uspdi/202318. html

>

> Ketorolac ( kee-toe-ROLE- ak) is used to relieve moderately severe pain,

> usually pain that occurs after an operation or other painful procedure.

> It belongs to the group of medicines called nonsteroidal anti-

> inflammatory drugs (NSAIDs). Ketorolac is not a narcotic and is not

> habit-forming. It will not cause physical or mental dependence, as

> narcotics can. However, ketorolac is sometimes used together with a

> narcotic to provide better pain relief than either medicine used alone.

Send instant messages to your online friends http://uk.messenger.

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Totally agreed Larry:

Recently removed from my protocols and rx inventory but never used it for

Renal Colic though?

I just didn't want to speak up first and get a bad rep.

Maybe nubaine/nalbuphine?

cheers

Wilf

Re: Re: FW: opiad analgesia

> When it first came out some years back, it was touted by many as the

> end-all in pain management. But in my experience it works poorly with

> musculoskeletal pain. I have given tons of it and am generally

> unimpressed.

> LT

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The narcotics laws in the Middle East and former soviet union, are, to put it

mildly, insane.

Here is info from the US Embassy in the UAE regarding importation of narcotics

and restricted medication.

http://uae.usembassy.gov/restricted_medication_.html

Note some of these restricted meds:

7, ACTIFED DM, Dextromethorphan 10mg , Triprolidine1.25mg, Pseudoephedrine

30mg/5ml, Linctus

22, ANEXATE 1mg/10ml, Flumazenil 0.1mg/ml, Injection

303, STEMETIL, Prochlorperazine maleate 0.1%w/v, Syrup

254, ROACCUTANE 2.5, Isotretinoin 2.5mg, Capsules

370, ZOLOFT, Sertraline 50mg, Tablets

Note the section:

.... " the Drug Control Department of the Ministry of health does have special

regulations for personal import of such items: patients or travelers carrying

prescribed prescription medications must have their prescriptions issued by

licensed U.S. doctors, attested by a notary public, and duly authenticated by

both the secretary of state of one’s U.S. state, and finally also authenticated

by the Secretary of State of the U.S. Government in Washington, D.C. "

So, all you need to do to bring your cough syrup with you to Dubai is a letter

from Condi Rice and a few lesser mortals.

This is not unusual. In many of these countries, the only time you get morphine

or other opioids for terminal cancer is if you have been admitted to the

hospital. No PCA pumps, no oxy-contin, etc. My mother-in-law in the FSU died

of lung CA that had metastasized to her femur, weakening it and causing it to

fracture when she fell down. For the pain she got ketorolac. The MDs are

also EXTREMELY reluctant to give opioids because of the paperwork and oversite

involved. I have seen Russian physicians withhold morphine from an acute MI and

from a guy who had his hand torn up by a power grinder, because of the strict

control of narcs.

In order to import these drugs, you need an import license from the government

of the country you are working in. These are, needless to say, virtually

impossible to get. Without this, most *suppliers* will not supply you with

anything other than Schedule 3 or 4 unless you have the import license.

So you either use something like Ketorolac, or you get creative. Making friends

with a local anesthesiologist is highly recommended.

If you are some place where the military is operating, you can try getting some

from them.

OTOH, n some places, such as parts of Africa, Pakistan, and until recently,

Afghanistan, you could buy morphine, valium, midazolam etc over the counter. It

makes life SO much easier.

Jim

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Yes, IV meds would certainly have a faster onset of action than oral.

I was commenting on overall pain relief.

As an alternative to narcs, Toradol would be better than acetaminophen

or nothing and faster onset than oral ibuprofen. OF course, 800 mg of

ibuprofen only requires a glass of water, and not an IV or IM

injection. My opinion only.

LT

RUDY VAN-DENTEN wrote:

> I agree with everything you wrote, and this is great for renal colic, but the

question asked was for an alternative to narcotics, with quick action

pain-relief in Libya due to country legislation. Another alternative mentioned

before, was Tramadol. Correct me if I am wrong, but shouldn't IV Toradol work

faster than oral Ibuprofen...if used for say renal colic. 800mg Ibuprofen

tablets (the big white dog) is very effective (personal experience) for

musculoskeletal pain....nothing less than 800mg.

>

>

> Re: Re: FW: opiad analgesia

>

> Ketorolac (brand name in the U.S. is Toradol) is an NSAID that is

> commonly used, but probably no more effective than oral ibuprofen in

> most cases. It has approximately the same COX 1/COX 2 profile.

>

> When it first came out some years back, it was touted by many as the

> end-all in pain management. But in my experience it works poorly with

> musculoskeletal pain. I have given tons of it and am generally

> unimpressed.

>

> It is outstanding for patients with renal colic - it provides almost

> magical pain relief for these people. For anyone else, give 'em 800

> mg of ibuprofen and you will have done just as much for them.

>

> LT

>

> medicrudy wrote:

>> Whilst in Iraq, the American Medics favoured this NSAID, as it can be

>> given IV as well for moderate to severe pain. Below is a short

>> discription. I have used it in a couple of cases, and it showed to be

>> quite effective. It seemed stronger than Voltaren.

>>

>> Hope this helps.

>>

>>

>> http://www.nlm. nih.gov/medlinep lus/druginfo/ uspdi/202318. html

>>

>> Ketorolac ( kee-toe-ROLE- ak) is used to relieve moderately severe pain,

>> usually pain that occurs after an operation or other painful procedure.

>> It belongs to the group of medicines called nonsteroidal anti-

>> inflammatory drugs (NSAIDs). Ketorolac is not a narcotic and is not

>> habit-forming. It will not cause physical or mental dependence, as

>> narcotics can. However, ketorolac is sometimes used together with a

>> narcotic to provide better pain relief than either medicine used alone.

>

>

>

>

> Send instant messages to your online friends http://uk.messenger.

>

>

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It is absolutely outstanding for renal colic. It's almost diagnostic

if you have a flank/abd pain pt and your trying to figure out if it's

stones or not.

LT

Wilf Mackie wrote:

> Totally agreed Larry:

> Recently removed from my protocols and rx inventory but never used it for

> Renal Colic though?

> I just didn't want to speak up first and get a bad rep.

>

> Maybe nubaine/nalbuphine?

>

> cheers

> Wilf

>

>

> Re: Re: FW: opiad analgesia

>

>

>

>> When it first came out some years back, it was touted by many as the

>> end-all in pain management. But in my experience it works poorly with

>> musculoskeletal pain. I have given tons of it and am generally

>> unimpressed.

>

>> LT

>

>

>

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>

> The Remote Medics Team

>

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