management of pain

Question 1

How many TCCC options for pain?

Answer 1

3

Question 2

What option for Pain control
-Mild to moderate pain and casualty IS still able to fight.

Answer 2

Option 1
TCCC Combat Wound Medication Pack (CWMP)
(a)Tylenol 625 mg bilayer caplet, 2 tablets q8h
(b)Meloxicam 7.5 to 15 mg PO daily

Question 3

What option for Pain control
-Moderate to severe
-Casualty IS NOT in shock or respiratory distress and casualty is NOT at significant risk of developing either.

Answer 3

Option 2
Oral Transmucosal Fentanyl Citrate (OTFC) 800 ug.
-Place between cheek and the gum, instruct the patient to not chew.

Question 4

What option for Pain control
-Moderate to severe pain
-Casualty IS in shock or respiratory distress OR casualty is at significant RISK ofeither developing either condition

Answer 4

Option 3
Ketamine 50 mg IM or IN (Intranasal) with repeat dose every 30 minutes
or
20mg IV or IO with repeat dose every 20 minutes

Question 5

What med is an alternative to OTFC if IV access has been established.

Answer 5

Morphine 5 mg IV/IO. Max of 15 mg.
-Reassess in 10 minutes and repeat as necessary to control severe pain. Ensure to monitor for respiratory depression.

Question 6

What is the dose for naloxone?

Answer 6

IV, IM, SubQ:
Initial: 0.4 to 2 mg; may need to repeat doses every 2 to 3 minutes.

Question 7

What is the consideration for opioid dependent patients

Answer 7

A lower initial dose (0.1 to 0.2 mg) should be considered to avoid acute withdrawal or if there are concerns regarding concurrent stimulant overdose.

Question 8

Zofran dosage

Answer 8

4mg PO/IV/IM q8 hours as needed