Fentanyl citrate

Question 1

What are the indications for fentanyl?

Answer 1

• Medicated Facilitated Intubation (MFI)
• Maintenance of sedation post MFI
• Analgesia (i.e. pacing, cardioversion, ACS, musculoskeletal injuries, headache etc.)

Question 2

What is the adult dose of fentanyl for analgesia?

Answer 2

25 - 50 mcg/dose prn SIVP/IO/IM. Provide lower dose if BP <90 systolic; (titrate to desired effect).

2mcg/kg IN to max single dose of 100mcg (50mcg per nostril), prn 5 minutes to total max of 200mcg

Question 3

What is the adult dose of fentanyl for MFI?

Answer 3

1 - 2 mcg/kg IVP (if systolic BP <90mmHg use ketamine)

Question 4

What is the adult dose of fentanyl for maintenance of sedation/procedural?

Answer 4

1 to 2 mcg/kg SIVP prn; titrate to desired effect

Question 5

What is the adult dose for fentanyl infusion?

Answer 5

1 to 2 mcg/kg/hr (usual dose is 50 to 250mcg/hr)

Analgesic doses are low while maintenance of sedation doses are higher. Used for long transports over 30 minutes.

Question 6

What is the pediatric dose for fentanyl?

Answer 6

1 to 2 mcg/kg slow IV push or IM

Question 7

What are the contraindications for fentanyl?

Answer 7

• Hypersensitivity
• Cross hypersensitivity may occur with meperidine
• MAO inhibitors within 14 days (may produce unpredictable, potentially fatal reactions).

Question 8

How do you set up a fentanyl infusion?

Answer 8

Mix 500mcg in a 100ml NS or D5W bag. This gives you a concentration of 5mcg/ml.