Virtual Drug Bag
PACKAGED: 100 mcg/2 mL (50 mcg/ml) vial
LOCATION: Intermediate Pouch, Controlled Substance Pocket
Suspected Cardiac Chest Pain, Trauma Emergencies, Extremity Fractures, Dislocations, Sprains, Frostbite, Abdominal Pain, Haz-Mat: Hydrofluoric Acid (Hf)
Fentanyl 50-100 mcg IN, repeat no sooner than 15 minutes.
Fentanyl administered up to 50 mcg slow IV/IO provided SBP > 100.
Repeat dose: may repeat up to 50 mcg after 5 minutes provided SBP > 100.
If unable to establish IV, Fentanyl 50 mcg IM; Repeat no sooner than 15 minutes and is only indicated when transport is greater than 15 minutes.
FENTANYL IS NOT TO BE ADMINISTERED TO ANYONE < 2 YEARS OF AGE.
For severe pain relief when the patient is conscious and alert the first choice is:
Fentanyl 1 mcg/kg IN, max dose 100 mcg.
May repeat Fentanyl 1 mcg/kg IN after 15 minutes, if an additional drug bag is available.
Consider Fentanyl 1 mcg/kg, slow IV, max dose 100 mcg, provided appropriate normal SBP (80 + 2x age in years).
May repeat Fentanyl 1 mcg/kg, slow IV after 15 minutes, max dose 100 mcg, if still in pain and appropriate SBP.
If unable to obtain IV: IM FOR PEDS IS A LAST RESORT.
Give Fentanyl 1 mcg/kg IM, max dose 100 mcg
Repeat dose of Fentanyl 1 mcg/kg IM, max dose 100 mcg, repeat no sooner than 15 minutes.
Provides analgesia, reduces cardiac preload by increasing venous capacitance and decreasing afterload
Hypersensitivity to drug/class/components
PRECAUTIONS AND SIDE EFFECTS:
Chest wall rigidity ("wooden chest syndrome") may occur preventing adequate chest wall excursion and ventilation. This syndrome typically occurs with high doses (6-7 mcg/kg) or with rapid administration. Reversible with naloxone.
Bradycardia which may be transient. Ensure adequate ventilation and oxygenation first. Treat with atropine only after these have been ensured. Use atropine only if the bradycardia is symptomatic and hemodynamically significant, and per the bradycardia protocol.
PEDI: Yes for repeat doses
Yes, for abdominal pain in peds