Protocol 2-660 - Pain Control

Polk, Hickory, Cedar, & St Clair EMS Protocols







Patient weight (lbs): (kg):
Patient height (ft): (in): (OPTIONAL, only needed if calculating ideal weight.)
Calculated ideal weight (lbs):

NEMSIS Protocol: 9914071 - General-Pain Control


Change Log:

DateLink to
Description of change
02/22/14pdfAdded medical control for Ketamine.
12/12/14Added weight-based dosage for greater than 65 yr for Fentanyl. Added IM option for Morphine. Added option for Toradol.
12/15/14Added Dilaudid medication.
05/05/15pdfModified Ketamine for chemical extrication (4 mg/kg IM and removed medical control).
08/06/15Added IM route for Fentanyl. Added IM route for Morphine. Added analgesic and disassociative doses of Ketamine. Added comment to half the dose of Ketamine if age over 65 yr.
11/17/15Modified over 65 yr old Fentanyl dose to 25-50 mcg with a max of 150 mcg.
04/06/16pdfAdded the need for medical control to administer the dissasociative dose of Ketamine. This was at specific request of CMH medical director.
06/29/16Added consider Benadryl with all Morphine administrations.
08/24/17pdfRemoved Ativan and Dilaudid. Added BLS pain control measures.
09/22/17Reduced all dosages for Toradol by 50% to align with NASEMSO. Increased Ketamine analgesic dose from 0.2 to 0.5. Removed hot pack under BLS pain control. Modified pediatric Versed dosages.
11/14/17pdfChanged minimum initial dosage of Fentanyl to 25 mcg to allow more flexibility.
08/24/18pdfAdded comment to consider capnography if narcotic used. Added option for Etomidate for procedural sedation of cardioversion. Removed maximum Fentanyl dose. Changed minimum adult Fentanyl dose from 25 to 12.5 mcg.
04/18/20pdfAdded content (without substantive modification) from old Protocol 6-050 - Control of Pain.
02/19/21pdfCorrected typo where Toradol can be administered both IM and IV to over 65 yr olds.
06/06/21pdfMoved to
11/05/21pdfAdded requirement for analgesic dose of Ketamine to be dosed from IDEAL body weight. This is a result of multiple requests from Dr. Nicholes even after a request to keep actual dose from protocol committee. Final confirmation from Dr. Nicholes on 6/8/21. Calculators updated to only give dose after patient height has been entered to accurately calculate IDEAL weight like the RSI protocol does for paralytics.
12/01/21Fixed an error with a link to Fentanyl.
02/28/22Updated link to Toradol.

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