Page 136 - Journal of Special Operations Medicine - Spring 2017

Appendix B Narcotic Cheat Sheet
Moderate Pain Pain Dose Range Sedation
Ketamine 20mg IV 0.1–0.2mg/kg IV 1mg/kg IV
Midazolam 1mg IV 0.5–2mg IV 1mg every 1–6 hours
Morphine 5mg IV 2.5–10mg IV
Fentanyl IV 25μg IV 25–100μg IV
Hydromorphone 0.5–1mg IV 0.25–2mg IV
OTFC 800μg pop: between cheek and gum
For overdose Naloxone: Dilute 0.4mg (1mL) with 9mL normal saline, repeat dose PRN
Flumazenil:
– Draw 1mL (0.5mg)
– Cut with 4mL sterile water (0.1mg/mL)
– Give 3mL/0.3mg over 15 seconds
– Additional 1mL/0.1mg every 1 minute PRN
– Maximum dose, 1mg/h (can cause seizures)
The moderate-pain category follows this clinical practice guideline philosophy: Prolonged field care analgesia/anesthesia
should begin with smaller amounts of a drug first: START LOW, GO SLOW. The doses are not all inclusive; therefore, the
dose by weight or a safe range is also included.
IV, intravenous; OTFC, oral transmucosal fentanyl citrate; PRN, as needed.

112 Journal of Special Operations Medicine Volume 17, Edition 1/Spring 2017