Sliding Scale Morphine for the Management of Severe Pain

By Robert Ben Mitchell

In 1997, a 40 year old male diagnosed with septic rheumatoid arthritis was admitted to the intensive care unit (ICU) of the hospital where I was employed. During his course of treatment, the sepsis invaded many areas of his body, including skeletal structures, resulting in the excision of several joints and his coccyx. Throughout much of his admission, this patient's pain was so severe that even the light pressure of laying a stethoscope on his chest produced agonizing reactions. Compounded by the complexity of his ongoing pathology, it was often difficult to keep up with his rapidly fluctuating level of discomfort. In an effort to balance his pain management needs against other medical considerations, including prolonged periods of intubation with mechanical ventilation, I synthesized a new protocol for administering IV morphine on a sliding scale where the infusion rate was matched to his systolic blood pressure measurements. This allowed the nursing staff to quickly adjust the medication's level and provide sustained pain control without adverse reactions. Ultimately, this patient succumbed to his ailments and passed away after four months of continuous admission and care in the ICU. It is noteworthy, however, that during this entire period, no other regimen provided as successful control of this patient's severe pain as did the IV morphine by sliding scale.Inquiries: trafn@yahoo.com or 786-262-5750 (USA)

• Format: Paperback
• Language: English
• ISBN: 1974466310
• ISBN13: 9781974466313
• Release Date: August 2017
• Publisher: CreateSpace Independent Publishing Platform
• Length: 42 Pages
• Weight: 0.25 lbs.
• Dimensions: 9.0" x 0.1" x 6.0"