EMT STANDING ORDERS:

• Routine patient Care.
• Assess pain severity. Consider all patients as candidates for pain management regardless of transport time.
• Have the patient rate his/her pain from 0 to 10, or Wong-Baker “faces” scale (appropriate for children ages 4 - 12):
• Document pain scale value each time assessed.
• For moderate to severe pain Call for AEMT/Paramedic intercept & Assisst them in patient care.

AEMT/PARAMEDIC STANDING ORDERS

• Routine patient Care.
• Assess patient for contraindications: GCS < 15 or mentation not appropriate for age, hypotension, SpO2 < 90% on 15L O2, hypoventilation, allergic to narcotics, condition preventing administration (blocked nose or no IV). If no contraindications may be considered:
• Fentanyl 1 mcg/kg IV/IM/IO/Intranasal (maximum initial dose 100 mcg).
• Administer slow over 2-3 minutes. (Fentanyl is preferred narcotic agent.) OR Morphine 0.1 mg/kg IV/IO (maximum initial dose 10 mg). Administer slow over 2 - 3 minutes.
• Reassess patient every 5 minutes. If no contraindications and patient still in moderate to severe pain may redoes fentanyl or morphine at 5 - 10 minute intervals at half the original dose to a total of 3 doses
• Contact Medical Direction for guidance with all patients with multi-systems trauma or for requests to provide additional doses of a medication.