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Questions and Answers
What is the recommended dosage of Ketorolac (Toradol ®) for adults experiencing mild to moderate pain?
Which of the following pain levels corresponds with the recommended use of non-opioid analgesia?
What should be avoided when administering Ibuprofen for pain management in adults?
For pediatric patients under 14 years requiring non-opioid analgesia, which resource should be consulted?
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Which intervention is recommended after administering BLS interventions if pain has not improved?
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What is the primary goal of pain management in the pre-hospital setting?
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What scale is used for assessing pain in patients?
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What should be done if a patient has established care plans that deter opioid pain management?
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What is the first step in the pain management protocol for any patient?
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For pediatric patients under 14 years, what is recommended when dosing medications?
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What modification might be necessary in pain treatment protocols based on patient condition?
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What score on the Wong Pain Scale represents no pain?
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In pain management, when is it appropriate to reassess a patient's pain level?
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What is the maximum single dose of opioids that can be administered to a pediatric patient aged 18 months to 14 years when MI MEDIC cards are unavailable?
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What is the total maximum dose of fentanyl for adults aged 14 to 65 years?
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When administering opioids to pediatric patients, how should the dosage be calculated for those under 14 years of age?
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What is the guideline for administering opioids to adults over 65 years of age?
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What is the minimum maintained systolic blood pressure for adult patients when administering opioids?
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What action should be taken if a patient develops nausea after receiving pain medication?
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How frequently can adults over 65 years of age repeat the dose of opioids when indicated?
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What is the recommended action if an IV is not available for opioid administration in pediatric patients?
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Study Notes
Pain Management Protocol
- Pain should be assessed and scored using the Wong Pain Scale
- Wong Pain Scale: Pain Assessment Scale:
- No pain (0)
- Minor pain (1-3)
- Moderate pain (4-6)
- Severe pain (7-10)
- Pain treatment should be based on the pain scale but may need modification based on patient assessment or condition being treated.
- Medical Control contact is required for patients with labor pains, established care plans that deter opioid pain management, or patients with established pain management care plans
- Initial intervention:
- Position the patient for comfort
- Utilize MI MEDIC cards for appropriate medication dosage for pediatric patients (< 14 years)
- When MI MEDIC cards are unavailable, utilize pediatric dosing listed within the protocol for pediatric patients.
- Opioid Analgesics:
- Fentanyl:
- Adults (patients > 14 years of age and < 65 years of age): administer 1 mcg/kg IV/IO/IN, rounded to the nearest dose 25, 50, 75, or 100 mcg, with a maximum single dose of 100 mcg. May repeat one time. Total dose may not exceed 200 mcg.
- Adults > 65 years of age: administer 0.5 mcg/kg IV/IO/IN, rounded to the nearest dose 25, 50 mcg, with a maximum single dose of 50 mcg, may repeat every 10 minutes up to three times (for a total of four doses). Total dose may not exceed 200 mcg.
- Pediatrics (patients < 14 years of age), refer to MI MEDIC cards. When MI MEDIC cards are unavailable:
- administer 1 mcg/kg IV/IO/IN.
- Fentanyl:
- Morphine:
- Pediatrics (patients > 18 months of age and < 14 years of age): refer to MI MEDIC cards. When MI MEDIC cards are unavailable:
- administer 0.1 mg/kg IV/IO (maximum single dose 5 mg). May repeat up to three times. Total dose may not exceed 20 mg.
- Do NOT administer Morphine to children < 18 months of age.
- Pediatrics (patients > 18 months of age and < 14 years of age): refer to MI MEDIC cards. When MI MEDIC cards are unavailable:
- If an IV is not available, a single dose of opioid may be given IM. DO NOT administer additional pain medications after IM administration without online medical direction.
- Administer opioids slowly when using IV or IO routes.
- Maintain systolic BP at >100 mm Hg for adult patients and > 80 + (2 x age) mm Hg for pediatric patients.
- If nausea develops with pain medication administration, refer to Nausea and Vomiting-Treatment Protocol.
Non-Opioid Analgesics
- Consider non-opioid analgesia for mild to moderate pain (described as 1-6 on the Wong Pain Scale).
- Acetaminophen:
- Adults (patients > 14 years of age): administer 650 mg PO.
- Pediatrics: refer to MI MEDIC cards. When MI MEDIC cards are unavailable, refer to the dosing table below.
- Ibuprofen:
- Adults (patients > 14 years of age): administer 400 mg.
- Do NOT use in pregnant patients.
- Pediatrics (patients > 6 months of age and < 14 years of age): refer to MI MEDIC cards. When MI MEDIC cards are unavailable, refer to the dosing table below.
- Ketorolac (Toradol ®)
- Adults (patients > 14 years of age): administer 15 mg IM/IV.
- Do NOT use in pregnant patients.
- Pediatrics (patients > 5 years of age and < 14 years of age): refer to MI MEDIC cards. When MI MEDIC cards are unavailable:
- Refer to [INSERT DOSING TABLE]
- Other Interventions:
- Administer BLS interventions per applicable protocol (e.g., positioning, splinting, ice, etc.)
- If not improved, consider analgesia.
- Start an IV if required for medication administration or per applicable treatment protocol.
- Refer to protocol "23 Vascular Access & IV Fluid Therapy-Procedure" for starting an IV.
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Description
Test your knowledge on pain management protocols including the Wong Pain Scale and opioid analgesics administration. This quiz covers guidelines for patient assessment and comfort positioning, along with pediatric medication dosing. Perfect for healthcare professionals seeking to enhance their understanding of effective pain management strategies.
