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
15 mg in 1 mL ampoule
| Colour assist: |
|---|
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
St John Ambulance Western Australia Ltd © Copyright 2020, All Rights Reserved