Adult Pain Management

Question 1

Adult Pain Management - BP > 90 medications

Answer 1

Morphine 0.1 mg/kg single max dose of 5 mg q 5 min to max of 20 mg
or
Fentanyl 1 mcg/kg single max of 100 mcg q 5 min to max of 250 mcg

Question 2

Adult Pain Management - BP > 90 maintenance medications

Answer 2

Morphine 5 mg q 10 to a max of 20 mg/hr
or
Fentanyl 50 mcg q 10 to max of 250 mcg/hr

Question 3

Adult Pain Management - BP < 90 medication

Answer 3

20 ml/kg bolus

Fentanyl 0.5 mcg/kg to single mac of 25 mcg q 5 min to max of 250 mcg

Question 4

Adult Pain Management - BP < 80 medication

Answer 4

Mandatory OLMC
Ketamine
0.2 mg/kg

Question 5

Adult Pain Management - Pain refractory to narcotics

Answer 5

Toradol 30 mg IV
or
OLMC - Ketamine 0.2 mg/kg

Question 6

Adult Pain Management - Considerations for pt over 65

Answer 6

Consider giving half individual doses of narctics

Toradol maxiumum 15 mg

Question 7

Adult Pain Management - nitrous oxide indications

Answer 7

Pain

Question 8

Adult Pain Management - nitrous oxide dose

Answer 8

Self-administered

prn

Question 9

Adult Pain Management - nitrous oxide EMS contraidications

Answer 9

Inability to follow verbal instructions
Intoxication with alcohol or drugs
Head injury with altered mental status
Thoracic injury suspicious for pneumothorax 
Abdominal pain and distension

Question 10

Adult Pain Management - nitrous oxide precautions

Answer 10

Invert canister three times prior to administration

Question 11

Adult Pain Management - Morphine indications

Answer 11

Pain

Question 12

Adult Pain Management - Morphine loading dose

Answer 12

0.1 mg/kg SIVP/IM/IO to a single max of 5 mg q 5 min prn to a total max of 20 mg

Question 13

Adult Pain Management - Morphine EMS contraidications

Answer 13

Hypersensitivity

Systolic BP 90 mmHg or less

Question 14

Adult Pain Management - Morphine precautions

Answer 14

Analgesic of choice
Use cautiously if ETOH or drug intoxication
May cause respiratory depression and hypotension
Use with caution with sedatives / depressants

Question 15

Adult Pain Management - Fentanyl indications

Answer 15

Pain

Question 16

Adult Pain Management - Fentanyl dose BP > 90

Answer 16

1 mcg/kg SIVP/IM/IO to a single max of 100 mcg q 5 min prn to a total max of 250 mcg

Question 17

Adult Pain Management - Fentanyl EMS contraidications

Answer 17

Hypersensitivity
MAOI therapy within last 14 days
Systolic BP less than 80 mmHg

Question 18

Adult Pain Management - Fentanyl precautions

Answer 18

Use cautiously if ETOH or drug intoxication
May cause respiratory depression
myasthenia gravis

Question 19

Adult Pain Management - Ketorolac indications

Answer 19

Pain refractory to morphine or fentaNYL

Renal colic

Question 20

Adult Pain Management - Ketorolac dose

Answer 20

30 mg IV/IM
15 mg IV/IM if 65 years or over
No repeat dose

Question 21

Adult Pain Management - Ketorolac EMS contraidications

Answer 21

Hypersensitivity to ketorolac or NSAID
Asthma
History of significant renal disease
Suspected intracranial bleed
History of GI bleeding
Sub-arachnoid hemorrhage 
Pregnancy

Question 22

Adult Pain Management - Ketamine indications

Answer 22

Mandatory OLMC – pain in hypotensive patients BP <80 or pain refractory to morphine or fentanyl

Question 23

Adult Pain Management - Ketamine dose

Answer 23

Mandatory OLMC – 0.2 mg/kg SIVP/IO

Question 24

Adult Pain Management - Ketamine EMS contraidications

Answer 24

Hypersensitivity

Conditions where a significant elevation of blood pressure is hazardous

Question 25

Adult Pain Management - Ketamine precautions

Answer 25

Can induce hypersalivation and tracheobronchial secretions

Question 26

Adult Pain Management - Morphine maintenance dose

Answer 26

5 mg SIVP/IM/IO q 10 min prn to a max 20 mg/hr

Question 27

Adult Pain Management - Fentanyl maintenance dose

Answer 27

50 mcg SIVP/IM/IO q 10 min prn to a max 250 mcg/hr

Question 28

Adult Pain Management - Fentanyl loading dose BP 80-90 mmhg

Answer 28

0.5 mcg/kg SIVP/IM/IO to a single max dose of 25 mcg q 5 min prn to a total max of 250 mcg