IV Opiates

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usalsfyre

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Currently revising the Clinical Operating Guidelines, and inserting options for pain management because of shortages. What's everyone carrying (besides morphine and fent) opiate wise?
 
Dilaudid.

Well, not anymore, since our fent shortage is no longer.
 
Well, unfortunately all we carry is morphine and fentanyl. However, before we got fentanyl, we carried Stadol...yeah, I'm being unhelpful lol.
 
Dilaudid and MS for opiates
 
Morphine and demerol for opioids, Versed for benzodiazepine, working on getting fentanyl.

I still wish we had Toradol. Great stuff.
 
If you have any possibility of getting it GO AFTER KETAMINE!
Let me let you in on a little secret that many physicians, services and even pharmacists don't yet know about this EXTREMELY old drug. It can be used in subdissociative dosing for analgesia that is 1000 times better then Dilaudid, Fentanyl or Morphine. The dosing for pain relief is 0.1mg/kg and may be repeated every 5-10 minutes. Our protocol on our aircraft and ambulances state that this is the go to for pain relief in any severe trauma situation or any obvious fracture or dislocation. The nice thing is that it totally gets rid of the pain and does not sedate your patient, and when you have trauma with low blood pressure it can actually help to slightly increase their blood pressure. The neat thing is that it for what ever reason ( still unknown) it does not artificially increase the blood pressure of a normotensive or hypertensive patient! If we have to use it as far as sedation, people (including most older physicians today) were always afraid that it will cause reemergence phenomenon and that can occur. However we use it for sedation and induction during RSI about 10 to 15 times a month and we might get one person a month who ends up with reemergence, and this is easily taken care of with 1-2 mg of ativan. Just some useful information.
 
Saw this thread hadn't been visited for a while.

What about nitronox. Self administered.... Quick acting..... And quick recovery when discontinued. Great for fractures, few whiffs and then move them.

Anyone else have it?
 
Fent is our Pain management drug, typically we do not use Ketamine for Pain management, we carry it for RSI, and give it prior to Cardioversion and give it for pain associated with pacing. If fent does not work we could get an order for the ketamine no problem. In the future this will most likely change, and we will see ketamine as a standard part of our pain management protocol, a Fent shortage will make it change even faster.
 
Well, the topic is about IV opiates ...

I know there's not many services carrying Nitronox because of both the difficulty in obtaining equipment and the potential for abuse.
 
Emtpbill said:
Saw this thread hadn't been visited for a while.

What about nitronox. Self administered.... Quick acting..... And quick recovery when discontinued. Great for fractures, few whiffs and then move them.

Anyone else have it?
Click to expand...

Used to. Our ILS Special events crews and ALS Ski Patrollers have it still. Always make a point of asking to borrow it to get people out of ski gear when we pick people up from the resort. Works like a charm.

As far as IV opiates, all we carry is fent and MS.
 
Anybody using Tramadol in the EMS setting? Just curious.
 
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