[Verse 1]
Trauma rolls in, burns covering the chest wall
Rib fractures plural, one bad breath can make you fall
Splinting every inhale, atelectasis creeping in
Regional's the weapon — thoracic epidural wins
Intercostal blocks, paravertebral, keep the lungs awake
Systemic opioids solo? That's a respiratory mistake
Multimodal stacking so the ventilation stays intact
Nerve catheters over narcotics — that's the clinical fact
[Chorus]
Cuatro escenarios, aprende bien
Trauma, células falciformes, el páncreas también
Cólico renal — los NSAIDs son el rey
ED stewardship, keep the tolerance in play
Cuatro escenarios, no los olvides
Individualiza, evalúa, y decides
[Verse 2]
Sickle cell crisis, the vessels clamp like a fist
Vaso-occlusive pain — don't put meperidine on the list
Normeperidine accumulates, seizures on the way
Individualized protocols, reassess without delay
Titrate IV opioids fast, thirty-minute check again
Hydromorphone or morphine, document the patient's baseline then
Warm compresses, hydration, NSAIDs bridging through
Rapid cycling reassessment — that's the protocol due
[Chorus]
Cuatro escenarios, aprende bien
Trauma, células falciformes, el páncreas también
Cólico renal — los NSAIDs son el rey
ED stewardship, keep the tolerance in play
Cuatro escenarios, no los olvides
Individualiza, evalúa, y decides
[Verse 3]
Pancreatitis burning through the retroperitoneal space
Renal colic squeezing, ketorolac takes first place
NSAIDs plus acetaminophen — the combo beats the pill
Acute low back pain, migraine, dental — same drill
Triptans for the cluster, NSAIDs kill the tooth
Opioids inferior for these — science gives the proof
Emergency department, steward every script you write
Functional restoration matters more than chasing analgesia height
[Bridge]
Ahora el paciente tolerante — baseline dose must stay
Add multimodal layers, don't just yank the med away
Higher breakthrough thresholds, the receptors saturated deep
Avoid the partial agonist — buprenorphine complicates the leap
Unless it's planned: continue bupe, split the daily dose
Add full agonist on top — titrate cautious, diagnose
Methadone patients keep their maintenance, don't withhold
QTc monitoring, interactions — read every fold
[Chorus]
Cuatro escenarios, aprende bien
Trauma, células falciformes, el páncreas también
Cólico renal — los NSAIDs son el rey
ED stewardship, keep the tolerance in play
Cuatro escenarios, no los olvides
Individualiza, evalúa, y decides
[Outro]
Regional blocks sobre la morfina sola
Sickle cell — meperidina, ninguna, ni una gota
NSAIDs primero cuando el diagnóstico te llama
Tolerate the tolerance — individualize the schema