We treated a patient c/o dyspnea, febrile, cough, generally unwell. I wanted to treat patient's chronic pain, new body aches, and sore throat with Tylenol and Advil, so I went through the contraindications and treated. Prior to giving Advil, I knew the pt had an ulcer 15 years ago and has no issues since. From my memory, I recalled the contraindications stated "current peptic ulcer". On review of the directive, I later saw it stated "history of peptic ulcer disease". In the future I will make sure I have the directive in front of me if I'm unsure. I think it would be a good idea to bring out my directives on calls if I haven't given medications in a while, so I refresh my memory on the wording. The patient had stated she had a duodenum ulcer and she has not for 15 years.” 

Can we get some clarification on “history peptic ulcer disease”, I have traditionally always viewed this a recent history, or something that is currently active, not a history of ever having ulcers.  

The Comprehensive Medical Directive Review that is currently being completed by the OBHG Medical Advisory Committee plans on better defining this contraindication for future versions of the Analgesia Medical Directive. However, for the time-being SWORBHP Medical Council would consider “history of peptic ulcer disease of GI bleed” as being currently treated for peptic ulcer disease or actively being treated for GI bleed.  

Analgesia,Pain/Sedation/Nausea

Active, analgesia, GI Bleed, Non-steroidal Anti-Inflammatories, NSAIDs, Patient history, Peptic Ulcer Disease, Remote

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