Acute Percocetopenia
Started by airwaymastaflex
If they have any recent visits for the same chronic complaint, and it's not cancer (or some other life-threatening disease), then Toradol and home.
If they have no recent visits I usually give them the benefit of the doubt and give them 12 vicodin.
What kind of book are you going to read that's going to help you deal with a drug seeker?
Each encounter is different but I generally given people the benefit of the doubt unless they have a significant visit history.
If they have an extensive history it's, a good physical exam...sorry you're in pain...here's some Motrin/Toradol/Tylenol...now follow up with your PCP if you need a refill on your opiates.
Each encounter is different but I generally given people the benefit of the doubt unless they have a significant visit history.
If they have an extensive history it's, a good physical exam...sorry you're in pain...here's some Motrin/Toradol/Tylenol...now follow up with your PCP if you need a refill on your opiates.
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Do any of you guys have a statewide narcotic registry? Alabama has one that's pretty useful. Any dispensed narcotics are recorded in the registry and you can log in with your DEA number and it lets you search a patient's narcotic history. If they just got 90 lortabs 5 days ago, I'm probably not going to be terribly sympathetic to their pain...
We don't have a registry that I am aware of.
Michigan has a website where you can look up all prescriptions filled by a patient. Called the Michigan Automated Prescription System, MAPS, accessible via https://sso.state.mi.us/
Texas has such a registry in the works. After the last legislative session, we had to start including our DPS number in addition to our DEA number (DPS is our state registry).
I looked into why this was being required and found out it is to enable the creation of this registry. We apparently have a useless (to EPs anyway) version of this registry which works on paper now. PCPs can write in and, several months later, get a list of the meds their patients have had filled.
Hopefully by the end of this year, Texas will have an online, realtime system for checking.
BTW, I give folks the benefit of the doubt as well. If they have multiple visits, I just say no.
Take care,
Jeff
I looked into why this was being required and found out it is to enable the creation of this registry. We apparently have a useless (to EPs anyway) version of this registry which works on paper now. PCPs can write in and, several months later, get a list of the meds their patients have had filled.
Hopefully by the end of this year, Texas will have an online, realtime system for checking.
BTW, I give folks the benefit of the doubt as well. If they have multiple visits, I just say no.
Take care,
Jeff
Yesterday, had a guy that looked familiar, with the exact same complaint I'd seen in the same part of the same ED recently (as there are at least 10 EDs in the driving area, and several have different sections), but he denied he'd seen me before. I did a little checking, and found that this guy had registered under a completely different name, with another made-up social security number (one that had, like the first time, never been issued), with a similar birthdate. More checking found that, on the last visit, his emergency contact was being seen at another ED in the health system at the same time, for a pain complaint. Here he is, though, not one month, not two weeks, but just 9 days later - and saying he didn't remember me.
When confronted by police, he gave up the whole game. Apparently, he was convicted a few years ago of some similar thing. What was interesting was the names; it was sort of a thing like: John Simon Ritchie, a/k/a Simon Richards, Richard Simons, Simon Johns, John Ritchie, Sid Vicious.
He was escorted out, to never return. However, those trespass orders seem to not be enforced.
When confronted by police, he gave up the whole game. Apparently, he was convicted a few years ago of some similar thing. What was interesting was the names; it was sort of a thing like: John Simon Ritchie, a/k/a Simon Richards, Richard Simons, Simon Johns, John Ritchie, Sid Vicious.
He was escorted out, to never return. However, those trespass orders seem to not be enforced.
