Assessing Pain
Pain is subjective, so use a consistent scale such as 0 to 10 numeric rating or the Wong-Baker faces for children. Ask about onset, quality, radiation, severity, and time using OPQRST. Reassess after every intervention and document the change.
Medication Options
Fentanyl and morphine are common opioid analgesics, with fentanyl offering faster onset and less histamine release. Ketamine at sub-dissociative doses and nitrous oxide are useful alternatives that spare respiratory drive. Acetaminophen and ibuprofen are appropriate for mild to moderate pain when scope of practice allows.
Monitoring and Reversal
Watch for respiratory depression, hypotension, nausea, and decreased level of consciousness. Continuous capnography is the best early warning for hypoventilation. Naloxone reverses opioid effects, and the goal is to restore adequate breathing rather than complete wakefulness.