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> My understanding of the literature is that opiods can actually improve the diagnosis of appendicitis.
--> I agree 100%.
And I know we here are the "converted" so I will not preach!
Perhaps (let me know) this was never an issue with PEM, but with adults we had HUGE problems with surgeons cursing us every time we gave morphine to abdo pains before they were clinically assessed by the surgeon...
Again, it is not US in EM who are the problem. We detort a testis - the urologies delays the exploration... We re-align the bones and the orthopods then fail to appreciate the mechanism of injury... We give analgesia which works and some other specilaty takes over then and underestimates sevrity (in the UK we tend to hand over complex patients to in-patient teams a bit earlier in some cases than happens in the USA and it is "tough" to explain properly what the patient looked like when he was in pain)...
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