Category Archives: Pediatric Analgesia

Have alternative pain control options such as oral morphine and nitrous oxide been (re)considered recently for pre-hospital administration? If not, what's the reasoning?

Just wondering, I have heard of a few coworkers putting the cardiac monitor on when giving acetaminophen and ibuprofen and others are not putting it on. I was under the impression that the monitor had to be on prior to giving medications. Is this a must or not?

I just have a question regarding analgesics. A contraindication for acetaminophen is “use of it within the last 4 hours”. Let’s say for an adult patient they took 500mg prior to EMS arrival, would it then be okay to administer an additional 500mg to complete the full max single dose of 1000mg or should you withhold the acetaminophen in honour of the contraindication?

As far as the contraindications for ketorolac and ibuprofen, what are the medications that are classified as anticoagulation therapy? I know daily ASA is not but are all blood thinners? Or just specific ones? We have been seeing a lot of eliquis and xarelto lately for example.

I have a question regarding analgesic administration in regards to abdominal pain (ex diverticulitis, hernia). If the pt is complaining of abdominal pain stating "it feels just like my diverticulitis acting up" Or due to hernia pain with evidence of a protruding hernia, would it be appropriate to consider analgesic medication if no contraindications are met? Although you are not 100% certain of the underlying cause in the pre hospital setting

If I want a faster onset of pain relief can I go straight to Ketorolac IV?

Can I only give Fentanyl if my patient doesn’t qualify for Morphine?

Question: An ACP is doing an inter-facility transfer of a 16 year old patient with a fracture. During the journey the patient's pain becomes severe in nature. The sending facility had been administering 1mg doses of Morphine with good effect however the medical directives would indicate that the paramedic should administer a 3mg dose of Morphine.

Can the paramedic elect to give a lower (1mg) dose since it has been already proven to be "the right dose" for this patient, or does this require consultation with a BHP

Question: With the expansion of Analgesia/pain relief being delivered to all paramedics. Is there going to be an addition to the standing order for the expansion of Ketorolac to the pediatric population either for ACP or PCP?

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!

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