Word: painfulness
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...just started a large-bore IV in the other. And while her big fat needle pierced him three or four times before it found blood, this stolid 60-year-old Eastern European block of a man had made not a sound. His face hadn't registered a flicker of pain, his arm stayed still, even his hand remained limp. No reaction to this needle torture promised an unsatisfying go at the VAS. But dutifully she administered. Protocol...
...That meant she was not even supposed to offer him a pain med; the purpose of the VAS is, among other things, to decide "scientifically" when to give pain drugs...
...Thank you doctor" came out as the cast hardened. I gave him his instructions. He did everything perfectly - including taking the pain prescription the way I told him to - every six hours for the first 24. And his arm healed and he went back to work...
...This patient had been in an automobile accident 48 hours earlier. After the accident she had gone home. She then came in to the ER the evening I was on call because she said her pain had become "excruciating - like I'm being stabbed with a thousand knives." Charlene complained of pain in her head and neck, both shoulders, upper back, lower back and one knee. There was not a mark on her. Between her physical exam, scans and X-rays, I was unable to find any abnormality other than nonreproduceable joint stiffness (they moved well except while I examined...
...least a 10. Can I put 11? Or 12? It's way off the scale." Vicki wrote 10 in the box. This meant she was supposed to give strong pain medicine, quickly. Another quick look from Vicki; she had only been in the room for two minutes with this patient yet she already had the same feeling, one that I was quite sure about: that there wasn't really that much pain here and that the VAS protocol (a hospital policy at that point) was wrong for this patient...