Pain Management Administrative Guideline Flashcards
History
- Past medical history
- Pertinent medication history
- Home pain medications
- Pain source
- Mechanism of injury (if known)
Signs and symptoms
Pain level - utilize the age appropriate
pain scale
- Pain exacerbation factors (i.e. movement, palpation, position, etc.)
Differential
Chronic vs trauma
Acute pain is
<72hrs onset
BLS does what?
O2 to maintain sat ? 94% Consider non-pharmaceutical pain management interventions
PM first step
IV/IO access
Cardiac monitor if indicated, consider 12-lead ECG
TFD morphine dosage
Administer morphine 0.1 mg/kg IV/IO
TFD adult dosing for morphine
administer 2-5 mg increments every 5 minutes, to a max
total dose 20 mg. Hold for hypotension
Consider nausea AG…
TFD pediatric dosing for morphine
<14 years administer 1-2 mg increments to a max total
dose of 8 mg. Hold for hypotension
What do you do if they are hypotensive?
“If becomes hypotensive, administer NS/LR 20 mL/kg bolus
May repeat as needed for continued hypotension”
Morphine not working/patient is allergic/patient is hypotensive?
If no relief from or allergy to morphine and/or hypotensive,
consider administration of ketamine 0.2 mg/kg
SIVP (max 30 mg first dose)
May repeat x 1 (max 20 mg 2nd dose)
Signs of emergence reaction
Administer midazolam (Versed) 0.1 mg/kg
(max 5 mg) IV/IO slow push as blood
pressure allows
After giving morphine
Reassess pain and repeat VS every 5 minutes
Non-pharmaceutical pain management techniques:
- Place patient in position of comfort for patient while still adhering to safe transport recommendations
- Supporting affected extremity as indicated
- Applying ice packs and/or splints
- Verbal reassurance/distraction
