Pain killers and the like.

Discussions of the best (or worst) equipment to have on hand for use in the event of an injury during an emergency.

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Pain killers and the like.

Post by ZombieCleaner » Mon Dec 31, 2007 4:54 pm

In a PAW situation, when you or one of your team members has become seriously injured (non-mortal gunshot wound, broken bone, etc.) and is in a great deal of pain, how will you cope with it?

I realize that some of us have access to narcotic type painkillers (dont start any illegal disscusions please), but for those who don't, what's your plan of action?

I for one know the value of a narcotic type pain killer in a situation where an OTC type (Tylenol, Advil, etc) wouldn't even take the edge off, not even a little bit.

So what would you do?

Cannabis?
Narcotics? (not ice, or pcp, etc.)

Please let me know if this type of disscusion is not allowed, thanks.
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Post by ZombieCleaner » Mon Dec 31, 2007 5:04 pm

Could a mod please move this to the "First Aid" section?

I can't belive I posted this here after being on the boards for so long...
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Post by Doctor Jest » Mon Dec 31, 2007 5:16 pm

Moved to first aid.

But, please avoid discussion of illegal activities.
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Post by Grin Reaper » Mon Dec 31, 2007 7:03 pm

Historically, alcohol in large quantities was popular for controlling severe pain; however, it has its own risks.

Treatment of severe pain should not be limited to 'merely' controlling the pain, but also the anxiety that frequently accompanies it. In Burn Units, anti-anxiety drugs (like Ativan) are as much a part of the treatment of burn pain as narcotic pain-killers (like morphine).

I'd like to ask the mods' indulgence here; I won't be encouraging anyone to do something that is illegal, or at least that was illegal when it WAS done, but would like to provide some interesting historical use of something which is now illegal.
Funny you should mention cannabis. My great-great granddad was a surgeon during and after the Civil War, and some of his old papers showed that he prescribed a lot of something called Tincture of Cannabis Indica for various 'nervous disorders' in surgical patients.
Here's a link to Boericke's Materia Medica, 1901 for more info on this drug that is no longer available http://www.henriettesherbal.com/eclecti ... nabis.html

Okay, back on-topic:
Without access to modern medications (especially the controlled substances like morphine, Demerol, etc.), you will be severely limited in controlling pain.

In the original post, the specific example of a broken bone was given. Pain control for this problem includes proper splinting of the injury, to avoid movement of the injured body part.
This is a low-tech and relatively effective means of managing the problem.

I strongly suggest the book A Comprehensive Guide to Wilderness and Travel Medicine by Eric A. Weiss -- a truly pocket-sized textbook suitable for all levels of 1st aid/medical training. This website (http://search.barnesandnoble.com/bookse ... 6800&itm=2) doesn't list a price, but I don't recall it being more than $15 when I picked mine up.

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Post by ninja-elbow » Mon Dec 31, 2007 9:55 pm

Years ago, 2002 to be exact, when I was a part time bouncer and full time student and had no dental coverage at all, I had great success with cheap whisky and buffered aspirin. I heard that could be bad for your guts though. I had a tooth that needed a root canal and had to wait 2 weeks for "services" to kick in and get me treatment I needed. I managed with shots of whiskey and generic aspirin.

I finally got some Vicodin prescribed 2 days before the procedure and boy was there a difference.
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Post by Ellie With An Axe » Mon Dec 31, 2007 11:59 pm

I have a tooth now that has an abcess and my dentist is booked up. I'm waiting for my extraction, but still. He only gave me a few days' worth of vicodin, and keflex for the infection.

Now that the vicodin is gone, I'm back to square one, which is waking up in the middle of the night consumed with "Cast Away" type ice-skate-blade-to-the-molar pain.

My solution is to use ice, and no more than 2000mg of Tylenol a day. I save 1000mg of that for Tylenol PM, which helps me sleep and gets me through most of the night. My back up solution is acetominophen for infants, ie in the eyedropper bottle, directly onto the gum and bone/tooth itself. This is really painful since it's so danged sensitive, but it kicks in in half the time, though only works for half the time as the adult Tylenol pills.

The other day while I was over at my mom's, I was in such pain that she laid me down in bed and stuck an aspirin on the infected root. After about an hour I actually fell asleep because it stopped hurting.

If I wasn't a recovering drunk, I'd be doing what my ex used to do, washing his mouth out with vodka. Unfortunately (or fortunately), I don't keep booze or anything stronger than OTC drugs in the house.

If I'm in worse pain than this, and I don't have anything strong enough to help, I take something to go to sleep, like Benadryl.

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Post by Buddha » Tue Jan 01, 2008 12:04 am

ninja-elbow wrote:Years ago, 2002 to be exact, when I was a part time bouncer and full time student and had no dental coverage at all, I had great success with cheap whisky and buffered aspirin. I heard that could be bad for your guts though. I had a tooth that needed a root canal and had to wait 2 weeks for "services" to kick in and get me treatment I needed. I managed with shots of whiskey and generic aspirin.

I finally got some Vicodin prescribed 2 days before the procedure and boy was there a difference.
I did the same when I needed time to get a wisdom tooth out. However I used panadine forte & Chivas Regal, why comprimise on taste just cause your in pain. :lol: . Although I would worry what this would do for staying on your A-game in a PAW. I remember I wasn't very useful for much @ the time.
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Post by Ellie With An Axe » Tue Jan 01, 2008 12:25 am

Buddha wrote:I did the same when I needed time to get a wisdom tooth out. However I used panadine forte
I've never heard of "Panadine Forte", so I Googled it. Here in the states it's Tylenol 3, or Co-Codamol.

Learn something new every day. :)

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Post by roscoe » Tue Jan 01, 2008 1:44 am

I just saved the Vicodin prescribed for my wisdom tooth removal. It has been useful now and again.

For skin injuries (burns, abrasions), you can get over the counter lidocaine in spray or gel. It came in real handy when hunting and my buddy grabbed a burning coal from the fire by accident. He was really suffering, but I put Boil-Eze on his hand every couple hours and he made it through the trip comfortably.

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Post by mr.trooper » Tue Jan 01, 2008 2:11 am

Vicodin... Hydrocodone... Acetominophen... Propoxyphene... Codeine... Or any other habit-forming narcotic pain reliever you can find.

NSAIDs like Oxaprozin, Naproxin, and prescription Ibuprofen (800+ mg) could come in hand as well.
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Post by Apollo-11 » Tue Jan 01, 2008 7:59 am

Ellie With An Axe wrote: The other day while I was over at my mom's, I was in such pain that she laid me down in bed and stuck an aspirin on the infected root. After about an hour I actually fell asleep because it stopped hurting.
Yeah, it's good to have a couple of extra vicodin floating around from old dental procedures. I don't think it really goes bad, it just slowly loses potency over time. (If someone knows otherwise, please correct me.) I seem to recall that the military did a big study on expiration dates, since they were throwing away zillions of dollars worth of stuff every year, and by and large there are only a few things that really go bad. Most just lose potency. So if you have a few painkillers left from a procedure, you might as well keep them (as long as they are kept safe from children, duh). It's totally legal to do so, as long as the prescription is in your name and it's in the original container. If you look clean cut and you have a good rapport with your dentist, you might be able to tell him that you would like an emergency supply (or if you go out into the backcountry away from emergency help for extended campouts) he might cave in and get you a scrip.

I have personal knowledge that you can take an aspirin and grind it up, put a little sugar in with it to help the bitter taste, and swish it around in your mouth with lukewarm water for as long as you can stand it. They also make a gum called Aspergum that really helps with tooth pain or sore throat.

Ellie, I understand that you may be able to put a little glob of Sensodyne toothpaste right near the pain (on the gum), leave it there, and the pain will lessen a bit. Good luck!

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Post by roscoe » Wed Jan 02, 2008 12:11 am

The other day while I was over at my mom's, I was in such pain that she laid me down in bed and stuck an aspirin on the infected root. After about an hour I actually fell asleep because it stopped hurting.
Usually the acid in aspirin (acetylsalicylic acid) will kill a nerve, if applied directly. Ground aspirin is a Wilderness First Responder treatment for a broken tooth.

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Post by phil_in_cs » Wed Jan 02, 2008 7:56 am

If you want to get <i>really</i> hard core, diethyl ether has been around since the 16th century, and used as an anesthesia since before the civil war. My great aunt was a missionary surgeon in China back in the 1920's and 1930's, and they manufactured the stuff on site.

This stuff is VERY dangerous, since it flashes easily and any flash kills the patient instantly since it burns the lungs from the inside out.

Supposed to be high school chemistry to make, <b>BUT</b> the main use for it these days seems to be for a solvent in making crystal meth, so if you poke around on the 'how to' issue you will attract LEO attention.

A good subject for research would be what could be done with 18th and 19th century tech, using 20 and 21st century know how.

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Post by crypto » Wed Jan 02, 2008 8:00 am

Ether is also used to start cars, it works real well for that :D
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Post by crypto » Wed Jan 02, 2008 8:01 am

Ellie With An Axe wrote:
Buddha wrote:I did the same when I needed time to get a wisdom tooth out. However I used panadine forte
I've never heard of "Panadine Forte", so I Googled it. Here in the states it's Tylenol 3, or Co-Codamol.

Learn something new every day. :)

Panadol and paracetemol are what those weirdos call acetaminophen (tylenol) over there.
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Post by Lady_Helfyre » Wed Jan 02, 2008 8:03 am

Ellie With An Axe wrote:I have a tooth now that has an abcess and my dentist is booked up. I'm waiting for my extraction, but still. He only gave me a few days' worth of vicodin, and keflex for the infection.
You need to ask your dentist for Clindamycin (sp?) for the infection. It's the best thing. Not a pain killer but it will kill the infection quickly and bring the pain down considerably.

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Post by JIM » Wed Jan 02, 2008 8:03 am

crypto wrote:
Ellie With An Axe wrote:
Buddha wrote:I did the same when I needed time to get a wisdom tooth out. However I used panadine forte
I've never heard of "Panadine Forte", so I Googled it. Here in the states it's Tylenol 3, or Co-Codamol.

Learn something new every day. :)

Panadol and paracetemol are what those weirdos call acetaminophen (tylenol) over there.
you bunch of Motrin-suckers... :wink:
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Post by crypto » Wed Jan 02, 2008 8:16 am

The new hotness for OTC pain relief is Naproxyn :D



Just to keep this on-topic, it is worth noting that it is all right to take the maximum doses of multiple types of OTC pain relievers.

For instance, if acetaminophen alone isn't getting the job done, you can simultaneously take the labeled dosage of aspirin, and ibuprofen, and naproxyn as well. Doing that is going to be easier on your stomach than just taking 800mg of ibuprofen 3x a day every time you twist an ankle.

When I had knee surgery I found that taking naproxyn and tylenol worked a lot better than the hydrocodone that was prescribed. Although, the hydrocodone with a scotch chaser was a pleasant way to spend the evening, all things considered.
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Post by Molon Labe » Wed Jan 02, 2008 8:31 am

A finger of vodka coupled with two 600mg motrins did the trick for me once (sprained ankle.) I still couldn't walk on it but it did wonders to kill the constant throbbing & keep the swelling at bay. I suppose in a PAW scenario, one could do the same using bath tub gin and Ibuprofen.

Does anybody know of an anti-inflammatory that could be found in the wild?
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Post by GanaEMT » Wed Jan 02, 2008 8:32 am

Crypto-- I was going to +1 you on that enjoyable way to spend an evening, but realized that we should never, ever, suggest or imply the mixing of narcotics and alcohol.



...but damn if that isn't a nice time.
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Post by crypto » Wed Jan 02, 2008 8:36 am

No, dont ever do it. It's bad and you will die.
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Post by phil_in_cs » Wed Jan 02, 2008 9:18 am

Molon labe wrote:Does anybody know of an anti-inflammatory that could be found in the wild?
Aspirin is made from willow bark.

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Post by Molon Labe » Wed Jan 02, 2008 9:38 am

phil_in_cs wrote:
Molon labe wrote:Does anybody know of an anti-inflammatory that could be found in the wild?
Aspirin is made from willow bark.
Awsome.

Just be sure to use caution when alcohol is being injested due to aspirin being an antiplatelet (blood thinner) as well. The mixing of the two could result in an anti-hemostatic effect (blood not clotting around an open wound and the patient eventually bleeding out), which would be the last thing that one would want with say a gun shot/stab wound.
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Post by phil_in_cs » Wed Jan 02, 2008 9:51 am

Molon labe wrote: Awsome.
Just be sure to use caution when alcohol is being injested due to aspirin being an antiplatelet (blood thinner) as well....
I really don't see alcohol as a pain killer. I know it can be a depressant, but it can also be an 'agitator'. You'd have as much luck clubbing someone into a concussion for pain relief.

Check this out: Civil War surgeon kits. Keep in mind the many amputations were done without anethesia or opiates. You can google up many more I'm sure. Pain relief was considered a distant second to patient survival.
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