Category Archives: Moderate to Severe Pain

Question: When administering Ketorolac, is it required that the medication is diluted prior to administration?

Question: My question relates to analgesia that I can provide patients as an ACP. If I have a patient that meets the indications and conditions for Morphine or Fentanyl under the ACP Core Pain Medical Directive, and if the patient’s discomfort is improving with the administration of the above narcotic analgesic, is it a requirement that I must proceed to administer Ketorolac?

Question: I have a few questions regarding the new analgesia and moderate to severe pain medical directives.

1. Could you be more specific on what you mean with "current active bleed"? Would this include the possible bleeding attributed with fractures? Blood in urine from damage caused by known kidney stones? Menstrual bleeding?

2. Could you elaborate on the condition of "patient must remain NPO or is unable to take oral medications" for Ketorolac? Does this mean it is only to be given if Tylenol/Ibuprofen cannot be given orally, or they should remain NPO after medication administration?

3. Should we avoid giving Tylenol/Ibuprofen/Ketorolac if patient has already self-medicated with other pain medications? i.e. Percocet, Demerol, etc.

Thank you in advance for your clarification.

Question: With the new PCP pain medical directives, I realize there has been a lot of debate over the age range. That being said, if we end up with a patient outside the age range (within reason), in severe pain, who does not meet any other contraindications, if a BH patch would be advisable for the possible administration of ketoralac? I realize that the patch orders are generally doctor specific but I was just unsure if these ages are set in stone or given special circumstances and orders if the rules can be bent. Thanks for the help!

Question: Couple of questions regarding the Musculoskeletal pain protocols:

To be clear, we are to give Acetaminophen and Ibuprofen OR Ketorolac. There is no case where we can give all 3 medications, as Ketorolac requires NPO?

Also Cardiovascular Disease means anyone with any hint of HTN, Athersclerosis, Dysrrhthmias, Heart Failure, and Peripheral Vascular issues, anything of the sort are not to get Ibuprophen?

And lastly for Ketorolac, is a daily ASA considered anticoagulation therapy?

Question: Is there any chance we will start giving acetaminophen to children with fevers (a temperature above 38 degrees) in the future? If not, what are the reasons why we can't add this to our protocols?

Question: I have a question regarding the Analgesia and Moderate to Severe Pain medical directives for torodol and narcotics. Can a narcotic analgesia and torodol be administered to the same patient on the same call if the ACP determines the patient's pain is severe enough and the properties of both analgesics would be beneficial given the situation? Or are we best to pick the most appropriate analgesia and possible consult with a BHP? Thanks for your time and input!