Simplifying prehospital analgesia. Why certain medications should or should not be used for pain management in the field.
Prehospital analgesia can be safely provided with only three agents: fentanyl, morphine and the mixed-gas nitrous oxide/oxygen. Of these three, fentanyl is by far the best agent for general EMS analgesic therapy by paramedics. However, to initiate prehospital analgesia earlier in the EMS response time frame, EMT's should administer nitrous oxide/oxygen. This protocol can easily be added to the EMT education program or through a continuing education session. All of the other agents discussed have absolutely no role in modern prehospital care.
Bledsoe
Bryan
B
George Washington University Medical Center, USA. bbledsoe@earthlink.net
Braude
Darren
D
Dailey
Michael W
MW
Myers
Jeff
J
Richards
Mike
M
Wesley
Keith
K
D000700:Analgesics / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use*; D019162:Anesthetics, Combined; D002077:Butorphanol / Q000009:adverse effects / Q000627:therapeutic use; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards; D004634:Emergency Medical Technicians; D005283:Fentanyl / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D020910:Ketorolac / Q000009:adverse effects / Q000627:therapeutic use; D008614:Meperidine / Q000009:adverse effects / Q000627:therapeutic use; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use; D009266:Nalbuphine / Q000009:adverse effects / Q000627:therapeutic use; D009609:Nitrous Oxide / Q000009:adverse effects / Q000627:therapeutic use; D010100:Oxygen / Q000009:adverse effects / Q000627:therapeutic use; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy*
D000700:Analgesics; D019162:Anesthetics, Combined; D009020:Morphine; D008614:Meperidine; D009609:Nitrous Oxide; D009266:Nalbuphine; D002077:Butorphanol; D010100:Oxygen; D005283:Fentanyl; D020910:Ketorolac