Morphine Sulfate

(Optional medication – not required for every BioTel agency)

Indications:

• Chest pain unresponsive to nitroglycerin
• Moderate to acute pain secondary to amputations, fractures, or other situations that cannot be controlled with nitrous oxide

Contraindications:

• Systolic BP  less than 90 mmHg;

BioTel may authorize administration in patients with systolic BP between 90 & 110 mmHg

• Head injury
• Severe respiratory depression
• Hypersensitivity
• Use with caution for OB patients in active labor (especially high-risk patients)

Precautions:

• Monitor respiratory status and blood pressure closely
• Have naloxone (Narcan®) readily available
• Prepare for assisted ventilation prior to administration

Side Effects:

• Hypotension
• Tachycardia
• Bradycardia
• Palpitations
• Syncope
• Facial flushing
• Respiratory depression
• Euphoria
• Bronchospasm
• Dry mouth
• Allergic reaction

Adult Dose:

Standing order:
Pain control

• 2 mg – 4 mg increments, every 15 minutes, up to a total, maximum cumulative dose of 8 mg

BIOTEL AUTHORIZATION REQUIRED IF patient:

• Is older than 65 years of age
• Is debilitated
• Has altered mental status
• Has a SBP less than 90 mmHg

Pediatric Dose:

Standing order
Pain Control:

• 0.05 mg/kg per dose, up to a maximum of 5 mg;
• May repeat once after 15 minutes, if needed;
• Additional dosing requires BioTel authorization
  

Route: Slow IV or IO push; IM

Drug Action:

• Alleviates pain
• Decreases peripheral vascular resistance – vasodilator
• Decreases cardiac workload and oxygen demand on the heart

Class: Narcotic Analgesic

Onset: 1 minute - 2 minutes following IV/IO administration

Duration: 2 hours - 7 hours

Antidote: Naloxone (Narcan®)