Fentanyl

(Optional medication – not required for every BioTel agency)

Indications: Pain relief

Contraindications:

• Severe hemorrhage
• Shock
• Known hypersensitivity
• MAO inhibitor use within the previous 14 days.

Precautions:

• May produce respiratory depression
• May produce bradycardia
• Use with caution in patients with liver and kidney dysfunction
• Use with caution for OB patients in active labor (especially high-risk patients)

Side Effects:

• Respiratory depression
• Temporary involuntary muscle contractions
• Bradycardia
  

Adult Dose:

Standing order:

• Pain relief unresponsive to or untreatable with nitrous oxide:
  • 1 mcg/kg slow IV/IO or IM or IN – Maximum single dose 100 mcg.
  • May repeat once after 15 minutes.
  • Do not exceed 200 mcg per patient, total, cumulative maximum dose without BioTel authorization.
• Sedation (with midazolam) prior to pharmacologically-assisted intubation (PAI):
  • 1 mcg/kg slow IV/IO push

BIOTEL AUTHORIZATION REQUIRED IF THE PATIENT:

• is at least 65 years of age;
• is debilitated;
• has altered mental status; OR
• has a SBP less than 110 mmHg.

Pediatric Dose:

Standing order:

• Pain relief unresponsive to or untreatable with nitrous oxide:
  • 1 mcg/kg slow IV/IO or IM or IN – Maximum single dose 100 mcg.
  • May repeat once after 15 minutes.
  • Do not exceed 200 mcg per patient, total, cumulative maximum dose without BioTel authorization.

BIOTEL AUTHORIZATION REQUIRED:
Sedation (with midazolam) 1 minute prior to pharmacologically-assisted intubation (PAI):

• 1 mcg/kg slow IV/IO – Do not exceed 100 mcg per dose
  

Route:

• IV or IO, slow push
• IM
• IN (Intranasal)
• SQ (pediatric patients)
  

Drug Action: Produces analgesic effects similar to, but about 50 to 100 times stronger than, morphine (the two medications are not chemically related).

Class: Opiate narcotic analgesic

Onset: Immediate; however maximal analgesia may not occur for several minutes

Duration: 30 to 60 minutes

Antidote: Naloxone