UNCONTROLLED WHEN PRINTED
Introduction
- A narcotic analgesic acting on CNS by binding with opioid receptors
- Also combines to cause respiratory depression, vasodilation, decreases gag reflex and slows AV node conduction
Onset & duration:
- IM: Onset 10-30 minutes, peak 30-60 minutes, duration 1-2 hours
- IV/IO: Onset 2-5 minutes, peak 10 minutes, duration 1-2 hours
Indications
- Analgesia
- Sedation to maintain intubation
Contraindications
- Hypersensitivity
- Late second stage of labour
Precautions / Notes
- Elderly patients
- Hypotension
- Respiratory depression
- Respiratory tract burns
- Patients on monoamine oxidase inhibitor
Management
Critical Care Paramedic only
Adult:
- IM: 5-10mg
- IV/IO: 2-5mg
- Repeat every 5 minutes
Sedation to maintain intubation:
- 1–20mg/hr IV/IO. Consider co-administration with Midazolam
- Commence at 5mg/Hr titrate to effect
Paediatric:
- IM: 0.1-0.2mg/kg
- IV/IO: 0.05-0.1mg/kg titrated to effect
- Maximum dose 0.4mg/kg
- Do not exceed 20mg
Sedation to maintain intubation:
- 0.1 – 0.2 mg/kg/hr IV/IO Consider co- administration with Midazolam.
- Single dose not to exceed 2.5mg
Special Considerations
- Bradycardia
- Hypotension
- Drowsiness
- Nausea and/or vomiting
- Pinpoint pupils
- Respiratory Depression
References
References
Presentation
15mg in 1ml ampoule
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Discarding unused medication must be witnessed and countersigned by attendant and credible witness.
Document Control
Directorate
Clinical Services
Responsible Manager
Head of Clinical Services
Date of Issue
Date of Expiry
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