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directives > Pain/Sedation/Nausea Directives > Flashcards

Pain/Sedation/Nausea Directives Flashcards

1
Q

Acetaminophen Conditions

A

> /=12
Unaltered

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2
Q

Ibuprofen Conditions

A

> /=12
Unaltered

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3
Q

ketorolac Conditions

A

> /=12
Unaltered
Normotension

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4
Q

Morphine Conditions

A

> /=1
Unaltered
Normotension

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5
Q

Fentanyl Conditions

A

> /=1
Unaltered
Normotension

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6
Q

Acetaminophen Contraindications

A

Use within 4 hours
Allergy
Liver disease
Active vomiting
Unable to tolerate oral meds
Ischemic chest pain

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7
Q

Ibuprofen contraindications

A

NSAID use within 6 hours
Allergy
On anticoagulation therapy
Active bleeding
Hx of peptic ulcer or GI bleed
Pregnant
Asthmatic without prior use of ASA or NSAIDs
CVA/TBI in 24hrs
Renal impairment
Active vomiting
Unable to tolerate oral meds
Ischemic chest pain

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8
Q

Ketorolac Contraindications

A

NSAID use within 6 hours
Allergy
Anticoagulation therapy
Active bleeding
Hx of peptic ulcer or GI bleed
Pregnant
Asthmatic without prior use
CVA/TBI in 24hrs
Known renal impairment
Ischemic chest pain

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9
Q

Morphine Contraindications

A

Allergy
Treatment of headache or chronic pain
SBP drops 1/3
Suspected ischemic chest pain
Active labour

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10
Q

Fentanyl Contraindications

A

Allergy
Treatment of headache or chronic pain
SBP drops 1/3
Suspected ischemic chest pain
Active labour

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11
Q

Acetaminophen >/=12 to <18 treatment

A

500-650mg x 1

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12
Q

Acetaminophen >/=18 treatment

A

960-1000mg

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13
Q

Ibuprofen Treatment

A

400mg x 1

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14
Q

Ketorolac Treatment

A

10-15mg x 1 IM/IV

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15
Q

Mandatory Analgesia Patch

A

Dosage verification for morphine or fentanyl <12

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16
Q

Morphine >/=1 to <18 dose

A

IV/SC
0.05-0.1mg

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17
Q

Morphine >/=1 to <18 max dose

A

5mg

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18
Q

Dosing interval morphine

A

15 min

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19
Q

Max cumulative morphine dose >1 to <18

A

10mg

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20
Q

> 18 Morphine dose

A

2-10mg

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21
Q

Max dose >18 morphine

A

10mg

22
Q

Max cumulative dose >18 morphine

A

20mg

23
Q

Fentanyl >1 to <18 dose

A

up to 1mcg/kg

24
Q

Max fentanyl single dose

A

75 mcg

25
Q

Dosing interval fentanyl

A

5 min

26
Q

Max doses fentanyl

A

4

27
Q

Max cumulative dose fentanyl

A

225mcg

28
Q

Dose fentanyl >18

A

25-75mcg

29
Q

Morphine Route

A

IV/SC

30
Q

Fentanyl Route

A

IV/IN

31
Q

Procedural Sedation Indications

A

Post-intubation
Transcutaneous pacing

32
Q

Conditions Midazolam procedural sedation

A

> /= 18
RR >/= 10
Normotension

33
Q

Midazolam Contraindications

A

Allergy

34
Q

Midazolam Dose procedural sedation

A

2.5-5mg

35
Q

Max Midazolam dose procedural sedation

A

5mg

36
Q

Dosing interval midazolam procedural sedation

A

5 min

37
Q

Max total dose midazolam procedural sedation

A

10mg

38
Q

Max # doses midazolam

A

2

39
Q

Combative Pt indications

A

Combative/violent/agitated behaviour that requires sedation for pt safety

40
Q

Midazolam Combative Conditions

A

> /=18
Normotensive
No reversible causes (hypoglycaemia, hypoxia, hypotension)

41
Q

Ketamine Conditions

A

> /=18
Normotension
Suspected excited delirium, severe violent psychosis
No reversible causes

42
Q

Contraindications Ketamine

A

Allergy
Known history of asthma
Known pregnancy

43
Q

Patch Point Combative

A

If unable to assess for normotension or reversible causes

44
Q

Midazolam Combative pt treatment

A

2.5-5mg q 5 x 2
Max 10mg total

45
Q

Ketamine >18 to <65 treatment

A

5mg/kg to max of 500mg x 1

46
Q

Ketamine >65 treatment

A

3mg/kg max of 300mg x 1

47
Q

Dimenhydrinate Conditions

A

> /=25kg
Unaltered

48
Q

Contraindications Dimenhydrinate

A

Allergy
Overdose on antihistamines, anticholinergics, or TCAs

49
Q

Dimenhydrinate treatment >25 to <50

A

25mg x 1

50
Q

Dimenhydrinate treatment >50kg

A

50mg x 1

51
Q

Gravel dilution

A

1:9

directives (4 decks)

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