Monday, 12 May 2008

The Right Tool

These days paracetamol is a very widely appreciated drug. Its an effective analgesic for mild pain and it has possitive effects in controlling a fever. However I feel this is a bad thing.

In hospital if a patient has a fever the doctors tend to put them on intravenous paracetamol. Paracetamol resets the hypothalamus. If your body had a central heating system which was overheating the paracetamol would be like turning it off and on again, when the system comes back up its at the right temperature(usually). This is aweful, whilst the patient is more comfortable because they no longer have a fever and have some mild pain relief, a diagnostically relevant symptom is being masked.

This patient could have a raging infection, or a mass in their brain, however the key sign pointing at the problem has been temporarily removed. As a student nurse I am meant to believe that its more important for a patient to be comfortable and pain free, however that is not how I feel. I would sooner have a patient correctly diagnosed earlier on with some pain and discomfort during the diagnosis than having a patient who isnt diagnosed until its too late to treat them.

This is one of my key gripes with the NHS today, its too cuddly. Let the patients grit their teeth and bare it, a little discomfort wont kill them, terminal cancer WILL kill them.


Sage said...

on some things I would agree, but if I have a migraine the more pain relief the better as I cannot cope with the pain of that particular event. Luckily I don't get them often or when I do they are gone usually within 24 hours though I tend to be a bit slow for another 24 hours afterwards for some reason.

Asclepius said...

My gripe isnt with the use of paracetamol as an analgesic. I dont even mind its use as an antipyretic outside of hospitals. Its in hospitals when a diagnostic tests should be carried out but arent. The last ward I worked on saw doctors hold off on blood cultures because the patient no longer had a temperature. Of course the patient didnt have a temperature you've just reset their bodys thermostat.