Morphine for Spectacular Psychiatric Efficacy

On call last night, got a spectacular consult. Elderly person w/ poorly controlled HIV, sent in from a facility. By report, “acting out and throwing self to floor, evaluate for psychiatric disease and 5150 danger to self please”. On exam this person was AOx0, slurring, mumbling, in obvious pain and distress, and unable to follow commands. On quick exam, turned out to have 1) Fresh R humeral fracture, 2) Recent femoral fracture, 3) Recent L humeral fracture, 4) Recent pelvic fracture. The “psychiatric disease” improved tremendously with pain control. Still had to explain patiently why a 5150 was not indicated.

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