Pain Management

Question 1

When Should pain management be avoided

Answer 1

if the patient’s systolic
blood pressure (SBP) is <90 mmHg, respiratory rate (RR) is ≤ 10 breaths per minute, and/or
decreased sensorium or suspicion of traumatic brain injury.

Question 2

Acetaminophen Dose

Answer 2

Acetaminophen For patients with mild to moderate pain)
* 1000 mg IV/IO infusion over 15 minutes.
* 1000 mg PO.
* Do not repeat.

Question 3

Fentanyl Dose

Answer 3

Fentanyl Citrate (For patients with moderate to severe pain)
* 1 mcg/kg (maximum single dose 100 mcg) slow IV, IO, or IN every 5
minutes. Maximum cumulative dose of 3 mcg/kg (300 mcg) total.

Question 4

Ketamine Dose

Answer 4

Ketamine (For patients with moderate to severe pain)
* Mix 0.3 mg/kg Ketamine (maximum single dose = 30mg) in 50-100cc normal
saline solution (NSS) or D5W and administer slow IV drip over ten (10)
minutes.
* If pain remains at, or returns to, moderate or severe, you may administer a
second dose of 0.3 mg/kg Ketamine (max dose=30 mg) in 50-100cc NSS or
D5W and administer slow IV drip over ten (10) minutes.

Question 5

Ketamine Contraindications

Answer 5

2. Ketamine should be avoided in the following patients:
   * Chest pain of suspected cardiac origin.
   * Pregnancy.