Pain Relief Flashcards
(22 cards)
What is the first action for mild pain?
Paracetamol oral
Paracetamol should not be used to treat chest pain in suspected acute coronary syndrome.
What should be assessed when managing pain?
- Reported level of pain (using pain scale)
- Physical signs of discomfort
- Acute vs. chronic pain
- Analgesia already taken
- Opioid tolerance
- Co-morbidities
These assessments help in determining the appropriate pain management strategy.
True or False: Paracetamol can be used to treat chest pain in suspected acute coronary syndrome.
False
Paracetamol should not be used in this context.
What is the first line treatment for moderate pain if IV access is available?
- Morphine IV
- Fentanyl IV (if specifically indicated)
- Paracetamol oral (unless contraindicated)
These options are for managing moderate pain effectively.
Fill in the blank: If IV access is not required, delayed, or unsuccessful for moderate pain, the preferred treatment is _______.
Fentanyl IN
Fentanyl IN is preferred in adolescents and elderly patients.
What is a second-line option for moderate pain if other options are unsuccessful?
- Ketamine IN (if minimal response to opioids)
- Morphine IM (if opioid not already administered)
These are considered when first-line treatments do not provide adequate relief.
What should be considered for severe pain with IV access available?
- Morphine IV
- Fentanyl IV
- Ketamine IN (consult for IV if pain remains severe)
Assess effectiveness after 3-5 minutes between doses.
What is the action for uncontrolled extreme pain?
Consider ETT as per CPG A0302 Endotracheal intubation
This is a critical intervention for managing severe pain.
What is a third-line option for severe pain if IV access is unsuccessful or delayed?
- Fentanyl IN
- Ketamine IN
- Methoxyflurane
- Morphine IM (if opioid not already administered)
These alternatives ensure pain management continues despite access issues.
What is the first line treatment for severe procedural pain?
Consider Ketamine IV - procedural dose
This approach is tailored for managing pain during procedures.
What should be done if transport time is prolonged and there is an ongoing need for Ketamine?
Ketamine infusion
This strategy addresses prolonged pain management needs.
What is the oral dose of Paracetamol?
1000 mg
OR 500 mg for patients < 60 kg, frail, elderly, malnourished, or with liver disease.
What is the inhaled dose of Methoxyflurane?
3 mL
Repeat 3 mL if required (max. 6 mL).
What is the IV dose of Morphine?
Up to 5 mg at 5 minute intervals
ALS Consult after 20 mg; no max dose.
What is the IM dose of Morphine?
10 mg
Repeat 5 mg after 15 minutes if required (once only) OR 0.1 mg/kg for patients < 60 kg, frail, elderly; no repeat dose.
What is the IV dose of Fentanyl?
Up to 50 mcg at 5 minute intervals
ALS Consult after 200 mcg; no max dose.
What is the IN dose of Fentanyl?
100 mcg
Repeat up to 50 mcg at 5 minute intervals if required (max. 400 mcg IN) OR 50 mcg for patients < 60 kg, frail, elderly; repeat up to 50 mcg at 5 minute intervals if required (max. 200 mcg IN).
What is the IM dose of Fentanyl?
100 mcg
Repeat 50 mcg after 15 minutes if required (once only) OR 1 mcg/kg for patients < 60 kg, frail, elderly; no repeat dose.
What is the IN dose of Ketamine?
75 mg
Repeat 50 mg at 20 minute intervals; no max dose OR 50 mg for patients < 60 kg, frail, elderly; repeat 25 mg at 20 minute intervals; no max dose.
What is the IV analgesic dose of Ketamine?
Consult only
10 - 20 mg at 5 - 10 minute intervals.
What is the IV procedural dose of Ketamine?
Consider 20 - 30 mg at 2 minute intervals until patient is dissociated or analgesia is adequate.
What is the IV infusion dose of Ketamine?
0.1 - 0.3 mg/kg/hr.
