[Fentanyl] Pre-Hospital Pain Management

[ffpm41]

My county in Washington State just replaced MS and Demerol with Fentanyl and it is still a standing order. As for not giving pain meds to patients, give me a break, GIVE IT!!! Until you are in a position where you didn't get pain meds for something like an extremity Fx, you don't understand the Px. People also have different pain tolerances, what might not hurt you might make someone else thing they're dieing of Px.

[PMedic850]

<!--sizeo:12--><span style="font-size:12pt;line-height:100%"><!--/sizeo-->hi to all.

Here in Germany we use both, MSI and Fentanyl on our Emergency Physician Units. We actually only use MSI in myocardiac-infarction(hope I'm spelling right) due to its pre-load reduction.

Fentanyl is used in every other situations were pain-relief is needed. We use a initial dose of 0.2mg Fenta.

There is also now a big discussion about Ketanest here. Schould be used in cerebral-bleeding because it lowers cerebral pressure and the patient won't have breathing-depression (good for multiple trauma). The problem is that the dosage is hard to handle and patiant needs simmultain Midazolam to prevent him from nightmares.<!--sizec--></span><!--/sizec-->

I know it's been a few years, but in reviewing this post, I think by "Ketanest" you may have meant Ketamine. Is this being used in Germany?

Thanks and hope all is well!

I know it's been a few years, but in reviewing this post, I think by "Ketanest" you may have meant Ketamine. Is this being used in Germany?

Thanks and hope all is well!

Also, an update for all that helped by commenting a few years back... NYS approved Fentanyl for ground ambulance use on 06/11/2007 with online medical control orders only.

[Kiwiology]

We have fentanyl for pre-medication prior to ketamine or midaz for RSI.

There is talk that it will be introduced to replaced MS.

Oh and for the record, if I have severe crushing chest pain or a life threatning asthma attack in LA City or the greater unincorporated areas of Los Angeles County covered by the rescue squads from LACoFD; I'm driving to Portland or Phoenix, heck maybe even Reno ... really, really, fast!

[Mark the O]

Galveston EMS has been using it since 2005 at least.