BMJ 1994;308:1159 (30 April)

Letters

Paramedics should give an opiate

EDITOR,--In their guidelines for the early management of myocardial infarction C F M Weston and colleagues state that ambulance staff do not give opiates.1 Although they recommend that ambulance services should develop protocols for the administration of oxygen, nitrates, and aspirin, they make no such recommendations about opiate analgesia. They do, however, acknowledge that this can be given safely.

In 1992 some paramedics of the then Plymouth division of Devon ambulance service who had been trained by the NHS Training Directorate were, after additional training, allowed to give nalbuphine not only to patients with myocardial infarction but also to patients with isolated fractures and burns. This achieved good pain relief with no important side effects.2 The service was not the first ambulance service to give the drug in Britain. Because of the success in Plymouth the drug is now being introduced throughout the Westcountry Ambulance Service Trust.

A combined response . . . [Full text of this article]


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Relevant Article

Guidelines for the early management of patients with myocardial infarction
C F M Weston, W J Penny, and D G Julian
BMJ 1994 308: 767-771. [Extract] [Full Text]

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