Joint Hospital Planning Council	Approved June 7, 2006
Treatment Guidelines	Page 1 of 1

PAIN MANAGEMENT

I. All patients will be evaluated for pain.

II. All patients will have their pain levels documented, using the 0-10 scale, on the patient care report.

III. Patients in severe pain (7-10/10), in whom a narcotic analgesic will have a beneficial effect on outcome should be considered as candidates for pain management. This includes, but is not limited to:

A. Extremity trauma.

B. Burns.

C. Suspected renal colic.

D. Abdominal pain.

E. ACS/MI unrelieved by O2 or SL NTG X3

IV. Any question regarding appropriate narcotic administration merits medical direction consultation.

V. If indicated, administer pain management:

A. Administer Morphine Sulfate slowly in 2-5 mg increments, to a maximum of 0.1 mg/kg IV.

1. Refer to “B”, below, if additional Morphine Sulfate is required.

2. If hypotension develops post Morphine Sulfate, place in Trendelenburg position.

3. If continued hypotension, administer fluid bolus of normal saline.

B. CONTACT MEDICAL DIRECTION FOR CONSIDERATION OF:

1. ADDITIONAL MORPHINE SULFATE

a) If hypotension develops post Morphine Sulfate, place in Trendelenburg position.

b) If continued hypotension, administer fluid bolus of normal saline.

2. DIAZEPAM (VALIUM) 2-10 MG IV FOR SEDATION.

VI. Documentation

A. An Emergency Department Physician signature must accompany all controlled substance use on the patient’s PCR.

B. If controlled substance was given under standing orders, note which dose(s) was standing order on PCR.

Note: If patient refuses pain management, document refusal on patient care report.

Issue Date: 6/7/06 Signature:___________________________________

	Date	Signature	Date	Signature
Reviewed
Revised