TB 182 Ketorolac

Question 1

____ is a highly effective analgesic used for the management of _______.

Answer 1

Ketorolac (Toradol) / mild to moderate pain

Question 2

Now a ____ item for the inventory of all advanced life support (ALS) resources per the Los Angeles County, Emergency Medical Services Agency.

Answer 2

mandatory

Question 3

Ketorolac is classified by the Food and Drug Administration (FDA) as a ______.

Answer 3

Nonsteroidal Anti-inflammatory Drug (NSAID)

Question 4

As such, it does not contain ____ and is not considered a controlled substance.

Answer 4

opiates

Question 5

Ketorolac is intended to be used for pain management in patients who have _____.

Answer 5

mild to moderate pain

Question 6

It may also be given to patients with moderate to severe pain in conjunction with opioids, or when contraindications to other _____ exist (e.g., hypotension, respiratory failure, opioid allergy).

Answer 6

analgesics

Question 7

Common uses for Ketorolac are for_____ and ____.

Answer 7

isolated extremity injuries/fractures / non-traumatic abdominal pain

Question 8

Contraindications:
Age <4 years old or >65 years old
Active bleeding
Allergy to NSAIDs
History of upper GI bleeding or peptic ulcer disease

Answer 8

History of renal disease or kidney transplant
Known or suspected pregnancy
Suspected sepsis or septic shock
Head injury

Question 9

Avoid in patients with ____ as this could increase the chance of kidney damage from contrast dye if the patient requires treatment in the cardiac cath lab.

Answer 9

cardiac chest pain

Question 10

Ketorolac may increase the ____ of other NSAIDs and enhance the antiplatelet effects of other antiplatelet medications (i.e., blood thinners).

Answer 10

adverse/toxic effects

Question 11

Ketorolac can be administered via the following routes:

Answer 11

Intravenous (IV)
Intramuscular (IM) (Lateral thigh is the preferred administration site)
Intraosseous (IO)

Question 12

Adults Dosing (One Time)

Answer 12

15 mg (1mL) slow IV/IO push, or

30 mg (2mL) IM lateral thigh or deltoid

Question 13

Pediatric (4 to 14 years old)

Answer 13

0.5mg/kg (15mg/mL) slow IV/IO push, dose per MCG 1309, or

1mg/kg (15mg/mL) IM, in lateral thigh, dose per MCG 1309. Maximum pediatric dosage is 15mg.

Question 14

Possible Adverse Effects

Answer 14

Abdominal Pain
Headache
Nausea

Question 15

Minimum inventory for both ALS Rescue Ambulances and ALS Assessment Companies is 60mg which can be in either:

Answer 15

(4) vials of 15mg/1mL

(2) vials of 30mg/2ml

Question 16

Each vial is ____. Once a vial is opened for use, any remaining product must be discarded and not retained for future use.

Answer 16

single-use only

Question 17

Due to its _____ qualities, careful attention to contraindications is required prior to administration to avoid administering it to patients on blood thinners, with a history of any _____, or who are at risk of internal bleeding, including head injuries and/or multi-system trauma.

Answer 17

platelet-inhibiting / bleeding disorders