A friend of mine is writing a book and there's a situation where a non medic administers morphine to a heroin addict after a gunshot wound.
I'm thinking 20mg subcut but would welcome any corrections?
Posted May 21, 2022, 6:27 PM UTC
Any opiate would be welcome to an opiate user, but let's start from the top.
What's the situation and where is the gun shot wound, we could give much better replies with more information.
In regards to morphine, different areas and services will have different protocols, but remember the person is a non-medical professional, so proper dosages will fly right out if the window, so ignore that shit.
Our morphine vials are typically 10mg in 1ml, but you may be able to get other strengths and sizes, but that is typical in the UK. You may want to state which country this happens in for greater accuracy.
Its very unlikely most non-medical people will even know what subcut is, so make it dramatic and smash that morphine straight into a big juicy muscle for extra effect. Subcut is generally slow release for Palliative Care, so I guess it could be appropriate for a gunshot victim, but I think they will need it a little bit faster acting. IM into a large muscle is easy enough and the general public will often know how to use an epipen, so will understand an IM injection goes into a large muscle. In regards to dose, 10mg in 1ml is what the vials are, and that is the dose we (in the uk) are recommended to give. If they are very tolerant of opiates, they could easily withstand a second 10mg injection. You could smash it in all at once, or give 1 and see how it goes and then give another shortly after as they realise the pain is still too bad.
Is they were a heroin user, it does beg the question as to why they have morphine rather than something stronger like Fentanyl.
Thank you! I believe the morphine is stolen from a trauma field kit, hence morphine not fent, and the subcut was my assumption due to non medic administration but you're right, mops would probably be more likely to whack it into a glute or something.
It's London, but the trauma kit is from Beirut.
If it's an old trauma field kit like the military used to use when our grandfathers we're stacking bodies and knocking up enough blonde German women to permanently alter the 3rd Reich's precious arian gene pool, the morphine would come in a syrette with 1/2 grain of morphine tartrate in it, and it was designed to be given sub-q. How many milligrams is 1/2 grain? About 32.4mg.
For realism, the victim should tell him that he's allergic to morphine, fentanyl, Tylenol, toradol, and tramadol and can only have dilaudid
Nice.
ETA: what's that medicine I can have, it begins with a d...
There’s quite a few factors her to consider:
Idk what else to add, but if this is based in U.k. I’m happy to have a look at any details to check it makes sense medically!
Morphine is usually dosed as 2, 4, or 8mg and is either administored IM or IV.
This. But also we've moved away from morphine in favor of fentanyl for the most part, though I can think of maybe a few occasions I used morphine as a medic in the Army. There's still a few situations where morphine is an optimal choice
Our protocol is 0.1 mg/kg to max of 10 single dose, repeating in 5 min to max of 20 total