Emergency Meds Rx

[WV Mountaineer]

Adam, muscle relaxers would do those spasms just right. I agree that pain meds should be temporary and not the best option for chronic pain. However tell that to the gy that has a messed up back, neck, etc.... What other options do they have once surgery, PT, and all other avenues have been exploited?

Thanks Poltax. For pointing out a situation where the strong prescription stuff was needed. I learned something today. As far as the others, nothing mentioned falls inside the question I asked unless the guy that James treated was able to get up and walk out with that broken bone after taking the heavy dope.

This is a thread based on opinions. I have mine and am every bit as entitled to post it. So far, I asked a question and have received one relevant reason why. If there are ore, please let me know. I'm never t old to learn something else. God Bless men

 

[Split toe]

Ibuprofen/Tylenol
Benadryl
Epi pen

That is a pretty well rounded backcountry med supply. Of course there is utility in opioids and they have their place, but to suggest you need morphine/fetanyl/dilaudid and some benzos are likely overkill. If you’re in that kind of pain you’d benefit more from a Inreach and hitting the SOS button.

 

[Trial153]

Who suggested that you should carry Morphine and Fentanyl in the back county?
Several people on here stated that narcotic based pain medication are not usefull for emergency situations requiring pain management.
I Showed examples where in fact narcotics are the primary venue for emergency based pain management. That is a fact.

Oral opioids like oxycodone and oxycontin without-question can be used effectively in emergency back county setting were an NSAIDs would be all but useless.

 

[Randle]

Good stuff here.
Tylenol
Benadryl
Imodium
Vitamin I
As for kidney stones , I have had 4 of those buggers over the years. I have found for me
I can take 4 vitamin I and pound the water, the water enlarges everything so they pass , vitamin I dulls the pain when they are hung up. I have never had them in the backcountry but I hope I have plenty of water to help them pass.

 

[oldgoat]

Yeah, I forgot, I carry some of the little packs of Neosporin too, but I don't consider that an Rx

 

[5MilesBack]

Adam, muscle relaxers would do those spasms just right.

Ya, but talk about not being able to function........muscle relaxants make me groggy, inattentive, and ready for bed. During the day, they are definitely a no-go. With the pain killers, they help to dull the pain so that I CAN function.

Nobody is saying that pain killers are mandatory items. Can you survive the backcountry and get yourself out without them.........yes. But if I have some, I can do it with less perceived pain and push harder........either way, I'm getting out.

Opioids have been around and used for decades without the problems you see today. Much like guns. But it seems that these days for whatever reason people always want to blame the object instead of the people. Yes, it would appear that people doing stupid stuff are much worse these days than it used to be. But don't blame the tools (or the manufacturers) for their problems.

 

[Riplip]

I/we extracted a hiker Monday afternoon that slipped on ice and fractured his acetabulum. Should I have given him Acetaminophen and stick to a bite on?
On second thought I went with fentanyl and then morphine.
Some of the holier then thou self Righteous bull shit that gets posted is just amazing.

Seriously? While I am sure that that the hiker was grateful for your assistance and the medication at the time, this statement is incredibly irresponsible and unethical. I assume that since you have prescriptions/availability to Fentanyl and Morphine that you have a significant amount of training and/or education in some form or other. As such I would also assume that you would have a better understanding of the implications and dangers of recommending these types of drugs on an open forum. At the absolute minimum you should have at least included some type of disclaimer or warning. No self righteousness bull shit, just common sense.

In regards to he OP's original question. I carry a prescription painkiller, antibiotic & asthma inhaler with me on certain occasions (travelling to a 3rd world country or if I am going to be in the back country for an extended period of time where emergency help is not readily available). I personally have never needed the medications, but I feel it is prudent to carry just in case. Each person should certainly consult with their physicians and just as important have a solid plan if you or someone you are with do become seriously injured or sick.

It is becoming harder and harder to get a prescription for opiods, which in my opinion is a knee jerk reaction - but that is a different topic all together.

 

[WV Mountaineer]

I’m certainly not one of those blamers. I live in the opioid abuse capital of this country. I’ll be the first to tell you it’s the person. Not the drug.

The drug has a very intended purpose. Watching somebody die of cancer drives that home. But, they aren’t intended to be used for “convenient” times. How people perceive those situations is going to determine when they are needed.

 

[Trial153]

Seriously? While I am sure that that the hiker was grateful for your assistance and the medication at the time, this statement is incredibly irresponsible and unethical. I assume that since you have prescriptions/availability to Fentanyl and Morphine that you have a significant amount of training and/or education in some form or other. As such I would also assume that you would have a better understanding of the implications and dangers of recommending these types of drugs on an open forum. At the absolute minimum you should have at least included some type of disclaimer or warning. No self righteousness bull shit, just common sense.

.

Spare the BS. Read the whole tread instead of taking people out of context. I never recommend to anyone to carry Morphine or Fentanyl nor any meds they weren’t prescribed.
The statement was made in response to posts( go and read them instead of cherry picking ) that narcotics have no place in emergency medicine. And that you should take a couple Tylenol and suck it up. In fact the opposite is true, narcotics are the primary medications used in emergency medicine for pain management.

 

[LostArra]

Spare the BS. Read the whole tread instead of taking people out of context. I never recommend to anyone to carry Morphine or Fentanyl nor any meds they weren’t prescribed.
The statement was made in response to posts( go and read them instead of cherry picking ) that narcotics have no place in emergency medicine. And that you should take a couple Tylenol and suck it up. In fact the opposite is true, narcotics are the primary medications used in emergency medicine for pain management.

You should probably follow your "read the entire thread" recommendation. No one said "take a couple of tylenol and suck it up". Just relaying current research. Numerous studies published from ER settings and oral surgery clinics show no difference in relief of moderate to severe pain from ibuprofen (600-800) combined with acetominophen (500-1000mg) when compared to oral opioids.

Here's one from the AMA that was easy to find:
https://media.jamanetwork.com/news-...-non-opioid-analgesics-treating-arm-leg-pain/

Sure there are exceptions where the euphoria of opioids may be beneficial like terminal cancer or kidney stones but we need to face the brainwashing of Americans and some American doctors that prescription opioids are the gold standard of all pain management. The problem has become the patients expect to receive opioids if they have any pain and any alternative meds, while safer, is in their minds useless strictly because it's otc.

The original question is what to put in your backpack. A handful of ibuprofen and acetominophen should work for what you might encounter excluding the black swan events. (cool term, I had to google it).

 

[pods8 (Rugged Stitching)]

Adam, muscle relaxers would do those spasms just right. I agree that pain meds should be temporary and not the best option for chronic pain. However tell that to the gy that has a messed up back, neck, etc.... What other options do they have once surgery, PT, and all other avenues have been exploited?

For me personally muscle relaxers make me more groggy/loopy than opiates, I used to get back spasms more (weak core, too much sitting in the office and commuting) and those times when my back would go out and I couldn't even sit up from bed (slide out to knees) I'd try to numb it enough with a pain killer first (actually first half a pill then 40-60min the other half if needed) and often that would be enough to allow me to continue moving around and be somewhat productive. If not then I'd take the muscle relaxer. Luckily being more active has drastically reduced those episodes.

The chronic pain issue I'll leave that for the pros to work on the best treatment method for an individual in chronic pain, I'm not a doctor. I've just casually taken notice of details coming out that opiates aren't really that effective in managing chronic pain and also sometimes they prolong it when folks are addicted. Their brain is telling them they're in pain and once they detox that back pain they reported drops way down on the pain scale. Not saying that is all cases but it is some of the cases. But that's really a different tangent entirely.

 

[Travis Bertrand]

From a pharmacist perspective there is truth in the expiration date is more linked to effectiveness. It is directly tied to when their is only 90% of the active ingredient remaining. I can also tell you some meds will degrade quicker than others depending on their physical makeup and excipients used.

It will also be harder to get opioids prescribed now than years past due to new recommendations by the CDC and FDA

Antibiotics are a touchy subject among pharmacist because they have been over prescribed for years. This has led to microbial resistance patterns. I also think if you have an accident and cant make it to medical attention prior to an infection killing you that you have bigger problems. Most healthy immune systems will fight off infections at least long enough to be evacuated. This may not be the case for poorly controlled diabetics or immunosuppressed individuals. Even drinking bad water and getting giardia or something is better treated with hydration than just abx.

Personally I only take tylenol, ibuprofen, and benadryl as medications anytime I'm hiking or in camping in the woods.

ditto, good luck getting opiates now.

I carry what you carry as well. I do throw a z pack in my truck though. I had a backpack hunt ruined because we failed to be prepared in that aspect and the wife needed to go to urgent care.

 

[Travis Bertrand]

That's what I currently have. I've probably had vicodin or similar prescribed 4 or 5 times just so I can carry it in my pack. My doc tells me to keep the old prescriptions - they don't expire but just gradually lose effectiveness over time (his words). I also take them when I travel to Mexico, etc. I try to renew these prescriptions every couple years. I think it helps if you have a long relationship with your doctor.

shoot, when I go to mexico i buy pharms!

 

[5MilesBack]

Numerous studies published from ER settings and oral surgery clinics show no difference in relief of moderate to severe pain from ibuprofen (600-800) combined with acetominophen (500-1000mg) when compared to oral opioids.

They can study and publish whatever they want, but personal experience is really the only thing that counts in these cases. If you read case study they'll also tell you that placebo's work on a large number of people as well, but I don't think packing sugar pills is going to be effective either. Everyone should make their own decisions on what they're packing, based on their own experiences and how their bodies handle medications. Man, this thread is as bad as "shot distance" threads. "There's no reason to ever shoot beyond 10 yards, regardless what your capabilities are". LOL.

 

[Split toe]

The statement was made in response to posts( go and read them instead of cherry picking ) that narcotics have no place in emergency medicine. And that you should take a couple Tylenol and suck it up. In fact the opposite is true, narcotics are the primary medications used in emergency medicine for pain management.

I must have misread or misunderstood your post, I agree they have their place in the ED setting, backcountry setting, no so much.

 

[Julius K]

I just can’t imagine that there are providers giving you guys pain meds for “just in case.”

I am a nurse, and I think every doc, PA, or
NP I have worked with would laugh in your face if you presented a “I just need these XYZ pain meds for my back country hunt where I hypothetically could get hurt.”

Is this really how you are getting these meds?




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[H82miss]

I carry epi, benadryl, aspirin, ibuprofen, and immodium.

 

[Travis Bertrand]

I carry epi, benadryl, aspirin, ibuprofen, and immodium.

What are you allergic to?


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[willfrye027]

Good luck getting a prescription for any controlled substance on a “just in case” basis.

Trained medical professionals doing S and R is a completely different situation.

 

[Fatcamp]

Great conversation. To the initial question some form of anti-diarreal and an anti-histamine would be good practice.

To those advocating self-medicating with narcotics I hope you have the proper training to do so. If the injury is so severe you need these types of medications shock is a very real possibility. Add respiratory depression from drugs to a patient going into shock and you could very well kill someone. Just my opinion of course.

To those carrying anti-biotics I hope you are honest with your care providers about what you have done when you get to a hospital or clinic. If you are randomly taking these drugs without lab tests and a full length of proper care you are helping to create the resistant strains of these bugs we are seeing more and more of. Honestly, do the right thing.