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Re: Injectable Morphine
Hi Ed,
I just talked to an old friend--Dr. Louis E. Shirley--who
ran a MASH unit in Korea, and we discussed the pros and cons of medical
procedures he did back in Korea in the early years of the war. Since he
was a new orthopedic surgeon back in 1950 I wanted the info about
morphine and pain--about a 1/4 grain shot of morphine at time of injury.
He drew a present-day comparison to illustrate how pain
was still treated today in good medical hospitals: "If you walked in or was
dragged into my office with chest pain, the very first thing I'd do would be to
give you 1/4 grain of morphine. At that instant I'm not interested in
anything else but sudden cardiac death and to lower your pain. What I and
my med staff need to do next to prevent further damage to your heart, but mainly
to dissolve the clot at fast as possible, is to start you on one or two of
the several powerful clot-busting drugs. That takes time to work and
sometimes leave the heart slightly damaged, or there is profuse hemorrhaging and
the medicine has to be changed. All this takes time and there is
risk. However, there is a rapid change taking place in such ER treatments
for heart attack presentations around the country: about one out of five
hospitals have the ability to perform "primary angioplasty." This
"primary angioplasty" brings immediate relief and a near total reversal of
any heart muscle damage downstream from the clot!. Best
of all, the clot is gone! This "primary angioplasty" has
seen to that. Of course, I'm assuming you get to the hospital within one
hour and NOT the next day!
"But I will not give more than two shots of 1/4 grain
morphine to relieve pain. If pain is that consistently severe, I
must move you to a large well-equipped full-time ER that has the latest
equipment to quickly perform a "primary angioplasty or offer better drugs than I
have!"
Ed, it's amazing how this drug and its dosage have hardly
been changed over the last 50 years! Your information was right on
target! Thanks.
Blake
----- Original Message -----
Sent: Thursday, October 23, 2003 9:38 AM
Subject: Re: Injectable Morphine
> Blake,
>
> During the early part of the Korean War evacuation of the wounded was
> generally a slow process involving transporting the wounded guy by
> man-carried litter to a battalion aid station from where he could
evacuated
> by ambulance/litter jeep over very poor roads to the
regimental clearing
> station (if the wounds were not too serious) or to
the nearest MASH. Later
> the helicopter sped up the evacuation
process from battalion aid station to
> MASH, thus saving a lot of
lives.
>
> But to your question about if morphine helped alleviate
pain during the
> evacuation process: It did and without it many
would have died from shock
> induced by moving the guy. As for the
four-hour period until the next shot,
> field medics were supposed to tie
a tag to the casualty and note the time
> he was given morphine on the
tag. This generally was done but rarely looked
> at down the evacuation
chain until the casualty indicated he was in extreme
> pain. At that
point the casualty would be given a second morphine injection
> is
sufficient time had passed from his first injection. I suspect
>
something similar would happen today in a mass casualty situation. I also
> suspect the information you quoted in the current manual about doing
this
> and that was put there to make the chairwarmers feel good.
<LOL>
>
>
> Ed Evanhoe, PO Box 916, Antlers, OK,
74523
> Life Member: Special Forces & Special Operations
Associations
> Author: DARKMOON: Eighth Army Special Operations in the
Korean War
> Web site: http://www.korean-war.com
>