Pain Management - Pediatric

Question 1

Pain Management - Pediatric:

What are the approved non-pharmaceutical pain management techniques when considering pain management?

Answer 1

➢ Splinting
➢ Icing
➢ Elevating the injury
➢ Utilizing positions of comfort
➢ Providing emotional support

Question 2

Pain Management - Pediatric:

At what level of pain, indicated by the patient, should the paramedic consider pharmaceutical pain management?

Answer 2

Pain severity > 6 out of 10 may be an indication for pharmacological measures.

Question 3

Pain Management - Pediatric:

What is the minimum age requirement in order to receive pharmaceutical pain management?

Answer 3

Minimum age requirement of 6

** >5 years of age **

Question 4

Pain Management - Pediatric:

What is the appropriate medication and dose for pharmaceutical pain management?

Answer 4

➢ Morphine sulfate, 0.1 mg/kg up to 5 mg IV.
➢ Fentanyl, 1 mcg/kg up to 50 mcg IV or IN.

Titrate either morphine or fentanyl up to the maximum initial dose

Question 5

Pain Management - Pediatric:

When should pharmaceutical pain management be withheld?

Answer 5

Evidence of:
➢ Hypotension
➢ Head injury
➢ Respiratory distress/depression
➢ Drug allergy

Question 6

Pain Management - Pediatric:

What medication should be administered in the event of respiratory distress secondary to opiate overdose?

Answer 6

Naloxone (Narcan)

Question 7

Pain Management - Pediatric:

If pain is still uncontrolled, can pediatric patients receive a repeat dose of pharmaceutical pain management?

Answer 7

Yes:
If pain is not controlled after 5 minutes, and vital signs are still adequate, administer second dose of Morphine or Fentanyl up to the maximum initial dose.

Question 8

Pain Management - Pediatric:

What is the maximum allowable dose of pharmaceutical pain management per CCEMS standing orders?

Answer 8

➢ 10 mg Morphine (5 mg with repeat of 5 mg)
➢ 100 mcg Fentanyl (50 mcg with repeat of 50 mcg)

Additional medication may be given with on-line medical control only