INCIDENT PAIN PROTOCOL <\/p>\n
St. Boniface General Hospital
\nPalliative Care\u00a0 <\/p>\n
Dr. Mike Harlos <\/p>\n
Step Medication # micrograms SL
\n(50 microgm\/ml) <\/p>\n
1 Fentanyl 50
\n2 Sufentanil 25
\n3 Sufentanil 50
\n4 Sufentanil 100 <\/p>\n
Application of Incident Pain
\nProtocol: <\/p>\n
Examples of situations in which
\nthe Incident Pain Protocol\u00a0
\nis initiated:\u00a0 <\/p>\n
– planned turns\u00a0
\n– transfers\u00a0
\n– bathing\u00a0
\n– changing clothes\u00a0
\n– dressing changes\u00a0
\n– disimpaction\u00a0 <\/p>\n
* The opioid (fentanyl or
\nsufentanil) is administered\u00a0
\nsublingually 10 min prior to
\nanticipated activity\u00a0 <\/p>\n
* If the initial dose appears to be
\ninsufficient, that same\u00a0
\ndose may be repeated up to two
\nfurther doses, at 10 minute\u00a0
\nintervals.\u00a0 <\/p>\n
* If a given dose is sufficient, the
\npatient will typically\u00a0
\nappear drowsy 10 – 15 min.
\nfollowing the dose. If this is\u00a0
\nnot the case, or if the patient
\nexperiences discomfort\u00a0
\nduring the planned activity, then
\nrepeat doses may be\u00a0
\ngiven as above.\u00a0 <\/p>\n
* Increasing to the next step of the
\nIncident Pain Protocol\u00a0
\nis undertaken if the maximum
\nnumber of doses (three) is\u00a0
\nrequired to achieve comfort, or is
\ninsufficient to achieve\u00a0
\ncomfort with activity. Increasing to
\nthe next step of the\u00a0
\nIncident Pain Protocol cannot be
\ndone within one hour of\u00a0
\nthe most recent fentanyl or
\nsufentanil dose, except after\u00a0
\ncontacting the physician. If the
\nmaximum number of doses\u00a0
\n(three) has been given, and the
\npatient remains in\u00a0
\ndiscomfort with activity that must
\nbe undertaken\u00a0
\npresently, the physician should be
\ncontacted for\u00a0
\nconsideration of immediately
\nproceeding to the next step\u00a0
\nof the Incident Pain Protocol\u00a0 <\/p>\n
* The Incident Pain Protocol may
\nbe used up to q 1h prn\u00a0 <\/p>\n","protected":false},"excerpt":{"rendered":"
INCIDENT PAIN PROTOCOL St. Boniface General Hospital Palliative Care\u00a0 Dr. Mike Harlos Step Medication # micrograms SL (50 microgm\/ml) 1 Fentanyl 50 2 Sufentanil 25 3 Sufentanil 50 4 Sufentanil 100 Application of Incident Pain Protocol: Examples of situations in which the Incident Pain Protocol\u00a0 is initiated:\u00a0 – planned turns\u00a0 – transfers\u00a0 – bathing\u00a0 –<\/p>\n