Pain/Sedation

Guidelines:

Medication for Pain and Comfort

1. Fentanyl (see guideline in med formulary)
   1. Pediatric Dose: 1-2 mcg/kg IV over 1-2 minutes may repeat prn every 1-2 hrs.
   2. Continuous infusion of 1 mcg/kg/hr (only for intubated patients).
2. Morphine (see guideline in med formulary)
   1. Pediatric Dose: 0.1mg/kg IV, may repeat prn every 5-10 minutes
   2. (Lower doses for non-intubated patients: 0.05-0.1 mg/kg IV).
3. Dilaudid (see guideline in med formulary)
   1. Pediatric Dose: 0.015 mg/kg, may repeat in 10 minutes for inadequate pain relief, then every 2-4 hrs prn pain (lower doses for non-intubated patients).

Narcan (Naloxone): the reversal agent for narcotics - see medication formulary for dosing information.

Medications for Anxiety and Comfort

1. Midazolam (Versed) (see guideline in med formulary)
   1. Pediatric Dose: 0.05-0.1mg/kg IV/IM
   2. Continuous infusion rate (only for intubated patients): 0.05-0.1mg/kg/hr (monitor hemodynamics).
2. Lorazepam (Ativan) (see guideline in med formulary)
   1. Pediatric Dose: 0.1mg/kg IV to max dose of 2mg. Avoid continuous infusion in pediatric.

Citations/References:

1. Acceptable pain scales per IU Health Pain Management Policy (CP 1.04 AP)