Guest guest Posted December 10, 2006 Report Share Posted December 10, 2006 Your patient presents with sudden onset dyspnea and localized chest pain. After taking a history, you suspect APE. However, the chest pain is of concern to the patient and she asks for some pain relief. Query: Can you give morphine or fentanyl or stadol safely to a patient with possible APE? Should you? Gene G. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2006 Report Share Posted December 11, 2006 The diagnosis of APE in the field is ALMOST non-existent and even then would rely on a history that clearly pointed out the increased risk that the patient was at such as recent surgery, DVT, etcl... Even the ECG changes are so subtle in nature that you would be one heck of a cardiac wizard to spot it! The main problem would be the Right Heart AFTERLOAD which potentially could lead the victim to hypotension. One of your keys is the localized CP here. Since the PE is not " cardiac " in nature and given that you suspect it, I would not consider treating the pain with any medication that involved vasodilatory effects or respiratory depression as they are certainly experiencing a ventilation-perfusion mismatch. Perhaps contacting medical control regarding the use of an anti-coagulant such as heparin would be in order. Great question Quote Link to comment Share on other sites More sharing options...
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