Which analgesic is given up to 1 mg IV/IO; may repeat after 10 minutes with physician order?

Which analgesic is given up to 1 mg IV/IO; may repeat after 10 minutes with physician order?

• A. Morphine Sulfate
• B. Fentanyl
• C. Hydromorphone
• D. Ketamine

Answer: (D)

The key idea is that some analgesics in prehospital protocols are given as a simple, fixed IV/IO dose with the option to repeat after a set interval if more pain relief is needed, under physician oversight. Ketamine is used this way: a fixed initial dose of up to 1 mg IV/IO, with the possibility to repeat after 10 minutes if the patient’s pain persists and a physician order is obtained. This dosing style is designed for rapid, reliable analgesia that can be titrated with medical direction. Ketamine’s analgesic effect comes from NMDA receptor antagonism, providing strong pain relief while often preserving airway reflexes and having a different respiratory profile compared with opioids. It can raise heart rate and blood pressure, which can be advantageous or at least manageable in certain trauma or shock situations, and it has a very rapid onset. In contrast, the opioid options are dosed differently: morphine and hydromorphone are typically given in mg with careful titration and can depress respiration; fentanyl is given in micrograms with frequent reassessment. Their dosing is not described as a fixed up-to-1 mg IV/IO dose that can be repeated after 10 minutes with physician order, which is why the ketamine option best fits the given dosing rule.

The key idea is that some analgesics in prehospital protocols are given as a simple, fixed IV/IO dose with the option to repeat after a set interval if more pain relief is needed, under physician oversight. Ketamine is used this way: a fixed initial dose of up to 1 mg IV/IO, with the possibility to repeat after 10 minutes if the patient’s pain persists and a physician order is obtained. This dosing style is designed for rapid, reliable analgesia that can be titrated with medical direction.

Ketamine’s analgesic effect comes from NMDA receptor antagonism, providing strong pain relief while often preserving airway reflexes and having a different respiratory profile compared with opioids. It can raise heart rate and blood pressure, which can be advantageous or at least manageable in certain trauma or shock situations, and it has a very rapid onset.

In contrast, the opioid options are dosed differently: morphine and hydromorphone are typically given in mg with careful titration and can depress respiration; fentanyl is given in micrograms with frequent reassessment. Their dosing is not described as a fixed up-to-1 mg IV/IO dose that can be repeated after 10 minutes with physician order, which is why the ketamine option best fits the given dosing rule.