Analgesia Medical Directive

Question 1

Analgesia Medical Directive

Answer 1

A Primary Care Paramedic may provide the treatment prescribed in this Medical Directive if authorized.

Question 2

Indications

Answer 2

Pain

Question 3

Conditions - Acetaminophen

Answer 3

Age: ≥12 years
LOA: Unaltered
HR: N/A
RR: N/A
SBP: N/A
Other: N/A

Question 4

Conditions - Ibuprofen

Answer 4

Age: ≥12 years
LOA: Unaltered
HR: N/A
RR: N/A
SBP: N/A
Other: N/A

Question 5

Conditions - Ketorolac

Answer 5

Age: ≥12 years
LOA: Unaltered
HR: N/A
RR: N/A
SBP: Normotension
Other: N/A

Question 6

Contraindications - Acetaminophen

Answer 6

• Acetaminophen use within previous 4 hours
• Allergy or sensitivity to acetaminophen
• Hx of liver disease
• Active vomiting
• Unable to tolerate oral medication
• Suspected ischemic chest pain

Question 7

Contraindications - Ibuprofen

Answer 7

• NSAID use within previous 6 hours
• Allergy or sensitivity to NSAIDS
• Patient on anticoagulation therapy
• Current active bleeding
• Hx of peptic ulcer disease or GI bleed
• Pregnant
• If asthmatic, no prior use of ASA or other NSAIDS
• CVA or TBI in the previous 24 hours
• Known renal impairment
• Active vomiting
• Unable to tolerate oral medication
• Suspected ischemic chest pain

Question 8

Contraindications - Ketorolac

Answer 8

• NSAID use within previous 6 hours
• Allergy or sensitivity to NSAIDs
• Patient on anticoagulation therapy
• Current active bleeding
• Hx of peptic ulcer disease or GI bleed
• Pregnant
• If asthmatic, no prior use of ASA or other NSAIDs
• CVA or TBI in the previous 24 hours
• Known renal impairment
• Suspected ischemic chest pain

Question 9

Treatment

Answer 9

• Consider acetaminophen
• Consider ibuprofen
• Consider ketorolac

Question 10

Consider acetaminophen

Answer 10

Age: ≥12 years to <18 years
Route: PO
Dose: 500-650 mg
Max. single dose: 650 mg
Dosing interval: N/A
Max. # of doses: 1

Age: ≥18 years
Route: PO
Dose: 960-1,000 mg
Max. single dose: 1,000 mg
Dosing interval: N/A
Max. # of doses: 1

Question 11

Consider ibuprophen

Answer 11

Age: ≥12 years
Route: PO
Dose: 400 mg
Max. single dose: 400 mg
Dosing interval: N/A
Max. # of doses: 1

Question 12

Consider ketorolac

Answer 12

Age: ≥12 years
Route: IM/IV
Dose: 10-15 mg
Max. single dose: 15 mg
Dosing interval: N/A
Max. # of doses: 1

Question 13

Clinical Considerations

Answer 13

Whenever possible, consider co-administration of acetaminophen and ibuprofen.
Suspected renal colic patients should routinely be considered fro ibuprofen or ketorolac.
IV administration of ketorolac applies only to PCPs authorized for PCP Autonomous IV.