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
Colour assist:

Discarding unused medication must be witnessed and countersigned by attendant and credible witness.

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Responsible Manager
Head of Clinical Services

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