Improvement in the patient’s respiratory effort is an immediate benefit for noting better control of the patient’s pain level. It may or may not be good that the patient’s vital signs remain the same. It is important that the vital signs improve to within normal limits for that patient. As much as you want to administer the medication quickly, it does not always improve the pain or discomfort. Likewise, conducting a patient assessment quickly is a good thing; however, it may not improve the patient’s condition.
Fentanyl is not administered by the intramuscular route. The least common route is transdermal.
Additional long-term benefits of pain control in pediatric patients include a decrease in long-term sequelae in children and a decrease in the development of hypersensitized pain pathways in children.
20% of the calls EMS respond are for painful conditions. Another way to put it is 1 out of every 5 patients have a painful condition.
The others are not considered barriers. In addition there are other barriers including: Fear of complications; Record keeping; Other care adequate; Perception of possible drug seeking; Not familiar with dosing; Criticism from hospital; Short transport time.
Offline protocols dealing with treating the pediatric patient’s pain is one means to overcome barriers to pain. Others include: Training (specific to assessing); Ability to administer pain medication without the need to first start an IV in children; Medical support and oversight; Coordination with and education of receiving facilities.
Any decreased mental status is a contraindication to receiving pain medication. Another reason not to administer pain medication is if there is a true allergy to the medication known.