Analgesia Medical Directive (ACP medications)

Question 1

Analgesia
Indications

Answer 1

PAIN

Question 2

MORPHINE
Conditions
AGE?
LOA?
SBP?

Answer 2

Age: ≥ 1 year
LOA: Unaltered
SBP: Normotension

Question 3

FENTANYL
Conditions
Age?
LOA?
SBP?

Answer 3

Age: ≥ 1 year
LOA: Unaltered
SBP: Normotension

Question 4

MORPHINE
Contraindications

Answer 4

1. Allergy or sensitivity
2. Treatment of Headache
3. Treatment of Chronic pain
4. SBP drops 1/3 or more of initial value
5. Suspected ischemic chest pain
6. Active Labour

Can be used for ischemia AFTER 3 nitro

Question 5

FENTANYL
Contraindications

Answer 5

1. Allergy or Sensitivity
2. Treatment of Headache
3. Treatment of Chronic Pain
4. SBP Drops 1/3 or more of initial value
5. Suspected Ischemic Chest pain
6. Active Labour

Question 6

Mandatory Patch Point for Analgesia?

Answer 6

YES
Mandatory patch point for DOSAGE VERIFICATION before administering MORPHINE or FENTANYL to < 12 year old patients

Question 7

MORPHINE
≥ 1 year to < 18 years
Route - IV / SC
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?
Max. Cumulative Dose?

Answer 7

Dose: 0.05 - 0.1mg/kg
Max. Single Dose: 5mg
Dosing Interval: 15minutes
Max # of Doses: N/A
Max. Cumulative Dose: 10mg

remember to patch for < 12 to confirm dose
reserved for severe pain

Question 8

MORPHINE
≥ 18 years
Route - IV / SC
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?
Max. Cumulative Dose?

Answer 8

Dose: 2 - 10mg
Max. Single Dose:10mg
Dosing Interval: 15 minutes
Max # of Doses: N/A
Max. Cumulative Dose: 20mg

reserved for severe pain

Question 9

FENTANYL
≥ 1 year to < 18 years
Route - IV / IN
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?
Max. Cumulative Dose?

Answer 9

Dose: up to 1mcg/kg
Max. Single Dose: 75mcg
Dosing Interval: 5minutes
Max # of Doses: N/A
Max. Cumulative Dose: 200mcg

reserved for severe pain

remember to patch for < 12 to confirm dose

Question 10

FENTANYL
≥ 18 years
Route - IV / IN
Dose?
Max. Single Dose?
Dosing Interval?
Max # of Doses?
Max. Cumulative Dose?

Answer 10

Dose: 25 - 75mcg
Max. Single Dose: 75mcg
Dosing Interval: 5 minutes
Max # of Doses: N/A
Max. Cumulative Dose: 200mcg

reserved for severe pain

Question 11

How often should aliquots be given to obtain desired dose?

Answer 11

q 3 minutes until desired dose

Question 12

Maximum amount of Fentanyl that may be administered IN per nare (mL)?

Answer 12

1 ml per nare