4-16 MORPHINE USE FOR PAIN RELIEF

LEARNING OBJECTIVE: Recall morphine dosage, administration routes, indications, contraindications, and casualty marking procedures.

As a medical technician, you may be issued morphine for the control of shock through the relief of severe pain. You will be issued this controlled drug under very strict accountability procedures. Possession of this drug is a medical responsibility that must not be taken lightly. Policies pertaining to morphine administration are outlined in BUMEDINST 6570.2, Morphia Dosage and Casualty Marking.

MORPHINE ADMINISTRATION

Morphine is the most effective of all pain-relieving drugs. It is most commonly available in premeasured doses in syrettes or tubexes. Proper administration in selected patients relieves distressing pain and assists in preventing shock. The adult dose of morphine is 10 to 20 mg, which may be repeated, if necessary, in no less than 4 hours.

Morphine has several undesirable effects, however, and a medical technician must thoroughly understand these effects. Morphine

Rigidly control morphine administration to patients in shock or with extensive burns. Because of the reduced peripheral circulation, morphine administration by subcutaneous or intramuscular routes may not be absorbed into the bloodstream, and pain may persist. When pain persists, the uninformed often give additional doses, hoping to bring about relief. When resuscitation occurs and the peripheral circulation improves, the stored quantities ofmorphine are released into the system, and an extremely serious condition (morphine poisoning) results.

When other pain-relieving drugs are not available and the patient in shock or with burns is in severe pain, 20 mg of morphine may be given intramuscularly (followed by massage of the injection site). Resist the temptation to give more, however. Unless otherwise ordered by a physician, doses should not be repeated more than twice, and then at least 4 hours apart.

If the pain from a wound is severe, morphine may be given when examination of the patient reveals no

CASUALTY MARKING

Morphine overdose is always a danger. For this reason, plainly identify every casualty who has received morphine. Write the letter “M” and the hour of injection on the patient’s forehead (e.g., M0830) with a skin pencil or semi-permanent marking substitute. Attach the empty morphine syrette or tubex to the patient’s shirt collar or another conspicuous area of the clothing with a safety pin or by some other means. This action will alert others that the drug has been administered. If a Field Medical Card is prepared, record the dosage, time, date, and route of administration.