Pain/sedation/Psych

Question 1

EMLA vs LET

Answer 1

LET can go on open wound

Question 2

fentanyl lollipops

intranasal fentanyl

-doses

Answer 2

lollipops: 5-10mcg/kg

IN: comparable to IV morphine. 1-2mcg/kg, 10min onset

Question 3

PO versed for anxiolysis

IN versed

dose

onset

Answer 3

PO versed: 0.5mg/kg, onset 20min

can use atomized buccal versed 0.3 mg/kg

also IN versed: 10min onset, 0.3mg/kg dose

Question 4

Ketamine for procedural sedation:

• age lower limit
• how long to push IV
• dose IV and IM

Answer 4

1. <3 months: resp complications
2. push 30-60 sec. faster can cause resp depression
3. IV: 1.5-2mg/kg (like adults)

IM: 4-5mg/kg

consider zofran for nausea

Question 5

propofol for procedural sedation

dose

onset time and duration time

Answer 5

1-2 mg/kg initial bolus

10-50 sec onset, 9 min duration

Question 6

What to use for motionless sedation? eg to get CT on child

Answer 6

brevital (methohexital) 1 mg/kg

onset in secs, 5-10 min duration. no analgesia

also pentobarbital