Fentanyl and Ativan In-Service . Eastern PA EMS Council. Fentanyl Oh What a Relief It Is! Pain Management .
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Eastern PA EMS Council
Fentanyl is used in the treatment of acute pain and to depress breathing in patients being ventilated. It may also be given as an infusion under the skin in palliative care patients who have intolerable side effects from Morphine
Opioids act on the opioid receptors in the nervous system to reduce pain.
Onset 7-15 minutes
Peak 15 minutes
Duration 1-2 hours
Duration 30-60 minutes
Opioid antagonist Narcan
Rash, Nausea, Vomiting (Zofran!!) Drowsiness, Dry Mouth, Dizziness, Difficulty Urinating, Constipation (prolonged use), Constricted pupils
Rigid chest wall, Decreased Breathing, Confusion, Hives, Itching, Slowing or Elevated HR, ABD pain, Flushing
Fast acting, Short duration, More potent than Morphine, ED’s increasing in use for all types of pain control even non-specific abdominal pain due to its short duration ( pt will unmask shortly after administration).
Also coming into favor in the presence of AMI due to less of a histamine release than Morphine which causes tachycardia!
New dosing mcg versus mg (double check your concentrations)
Drug most likely to be abused by providers!
Treat as you would any controlled substances we carry, i.e. double lock box, accountability forms checked for accuracy routinely
Relatively potent anxiolytic effects and its best known indication is the short-term management of severe anxiety.
Sedative/Hypnotic effects and the duration of from a single dose make it useful for short term treatment of insomnia.
As an anticonvulsant intravenous Ativan is a reliable agent for terminating acute seizures.
In the violent agitated pt including acute delirium Ativan can be used. Watch for paradoxical effects, should be given with Haldoperidol.
Given to CA patients as it has some antiemetic properties.
Adult 1-2mg IVP/IO repeat q5 minutes until max dose of 8mg is reached (0.1mg/kg max 4mg dose)
Pediatric 0.1mg/kg IVP/IO max 4mg dose repeat q5 until max dose of 8mg is reached.
(Titrate to minimum amount necessary)
Agitated/Violent Behavioral Patient
1-2mg IVP/IO/IM or 0.1mg/kg max 4mg dose may repeat q5 until max dose of 8mg