General Approach to All Pediatric Patients

Pain Management - Pediatric

Advanced Life Support

Analgesic agents may be administered if patient has severe pain and one of following:

    • Isolated extremity injury
    • Burn without airway, breathing, or circulatory compromise
    • Typical sickle cell crisis for patient
    • Animal bite or envenomation
  • Agents for pain control:
    • Fentanyl (Sublimaze) 0.5 mcg/kg (maximum 25 mcg) slow IV; repeat once after 5 minutes as needed (maximum 50 mcg total dose) OR 1.5 mcg/kg (max 100 mcg) intranasal via MAD (divide dose equally between nostrils)
      • Preferentially use intranasal delivery via MAD for those where IV access may be difficult to obtain in a timely fashion
  • Assess and record the patient’s pain level after medication
  • Note adequacy of ventilation and perfusion
  • Record & monitor continuous 02 saturation and microstream capnography