PCFP/ACP: Moderate to Severe Pain (E08: Pain Management)

• Loading dose: IM/IV/IO: 0.5 – 1mcg/kg (Max dose 100 mcg); Usual dose: 25-50mcg q5 minutes prn (Max total: 300mcg/hour)
• Loading dose: 1.5 – 2 mcg/kg IN (Max dose 100mcg); usual dose: 50-100mcg q 5 minutes prn (Max total: 300mcg/hour)
• PR11: Intranasal Medication Administration

Once initial pain control is achieved, consider multimodal analgesia to support pain control

• Maintenance dose for long conveyances: IM/IV/IO: 25 - 50mcg q 10 minutes prn; (Max total 250mcg/hour)
• Maintenance dose for long conveyances: IN: 50 – 100mcg every 10 minutes prn; (Max total dose 250mcg/hour)

CliniCall consultation required prior to administration of higher doses

PCFP: CCP-A Consultation Required

PCFP/ACFP/CCP: Moderate to severe pain (infusion)

• 25-100 mcg/hour and titrate to effect

PCFP:  CCP-A Consultation Required

Follow weight-based dosing

NB: If vascular access is unavailable, the preferred route of administration for fentanyl is intranasal – intramuscular absorption rates are inconsistent in children.

PCFP/ACP: Moderate to Severe Pain (E08: Pain Management)

• Loading dose:  1.5 – 2 mcg/kg IN (Max 100mcg). Do not repeat.
• PR11: Intranasal Medication Administration
• Loading dose: 1-2 mcg/kg IV/IO (Max 50mcg) q 5 minutes prn ; (max total 200mcg/hour)

Fentanyl is preferred over ketamine. Once initial pain control is achieved, consider multimodal analgesia to support pain control. 

• Maintenance dose for long conveyances: 0.75 – 1.5 mcg/kg IN q 10 minutes prn; (maximum total 150mcg/hour)
• Maintenance dose in long conveyances: 0.5mcg/kg q 10 minutes prn; (max total dose 150mcg/hour)

PCFP:  CCP-A Consultation Required

PCFP/ACFP/CCP: Moderate to Severe Pain (infusion)

• 1-5 mcg/kg/hour and titrate to effect

PCFP:  CCP-A Consultation Required