1-5. Pain Reduction

isolated extremity trauma / significant burns. — selectively and cautiously, with goal of partial relief of pain while avoiding: over sedation, hypotension and obscuring head or torso injuries.

1) O2 / NS IV at TKO

2) If BP >100 mm Hg

a) Morphine Sulfate 2 mg IV; OR

b) Fentanyl 50 mcg IV.

If BP is still >100 mm Hg, may repeat:

For other severely painful conditions, commo.

If respiratory depression or difficulty after administration of pain medication, support respiration as needed, avoid a full reversal with Naloxone. If necessary give Naloxone 0.5 mg IV and repeat as needed up to a total dose of 2mg.

If the IV has been lost, administer Naloxone 2mg intranasal (IN) using an atomizer or mister device. You must use the higher concentration form when administering Naloxone IN.