Analgesia and Sedation SOP

Question 1

Outline the contents of the analgesia and sedation SOP

Answer 1

No patient should remain in pain once the LNAA team have arrived

General principles and guidance
Available drugs
Intranasal drugs
Antiemetics
Agitation
Safety and monitoring
Administration of sedative medications

Question 2

Outline the general principles discussed in the sedation and analgesia SOP

Answer 2

No replacement for care, reassurance and good rapport

Assess analgesic requirements in all patients
Label your syringes
Estimate weight agree with team
Ideally deliver IV and titrate to effect
Other routes are available
Document in CD books

Question 3

What is the dosing of Ketamine as per the analgesia and sedation SOP?

Answer 3

IV Analgesia 0.3
IV Sedation 0.5-1
IM Sedation 3-5

Question 4

Over what age can you use a fentanyl lozenge?

Answer 4

6

Question 5

How long does it take for a fentanyl lozenge to be consumed?

Answer 5

15 mins

Question 6

What is the dose of paracetamol for paediatric patients or adults <50kg?

Answer 6

15mg/kg

Question 7

Describe the administration of IN medications

Answer 7

Use a MAD
Don’t sniff
Occlude other nostril
Half the dose in each nostril
Max 1ml per nostril

Question 8

What antiemetic do LNAA carry?

Answer 8

Ondansetron
In the medicines pouch in the blue bag
2 vials

Question 9

Describe the practicalities of sedation as per the analgesia and sedation SOP

Answer 9

Tricky if trapped or access difficult
Need 360 access
AAGBI monitoring - remember nasal ETCO2
Ensure that resus equipment including BVM are to hand

Don’t pass CDs between crews