Sedation/Analgesia in Mechanically Ventilated Patient Clinical Pathway — CICU
Sedation/Analgesia in Mechanically Ventilated Patient Clinical Pathway — CICU
Breakthrough Opioid Dose for Pain (Pain > 4)
Patients on intermittent morphine or hydromorphone (PO or IV)
- Give a PRN dosed equivalent to the standing opioid dose (IV or PO).
- Applies to patients on doses higher than initial starting doses due to opioid tolerance unless the dose is less than an initial starting dose in an opioid-naïve patient, in which case a treatment dose of morphine (per CHOP Formulary) should be administered.
Patients on continuous opioid infusion
- Give a bolus dose equivalent to the amount of opioids administered over 1 hour.
- Consider continuing benzodiazepine wean first if a patient is stable and pain is not musculoskeletal in nature.
- Resume opioid wean when pain is resolved or controlled.