Concurrent alcohol/drug intoxication is a relative contraindication: the source allows consideration only after base contact when intoxication is not significant and the patient is not lethargic or otherwise impaired.
Use in OCEMS
PR-70 addresses moderate–severe pain (4–10) when fentanyl is not a safe or appropriate choice. Examples include opioid intolerance/refusal, hypotension, or concern about airway/ventilatory status.
This is the analgesia procedure, not a field dissociative-sedation or pediatric ketamine protocol.
Adult / adolescent
Indication / route
Dose & limits
IV — preferred when practical
0.1 mg/kg slowly over 1–2 minutes, maximum 10 mg. May repeat once after 15 minutes.
IM
0.5 mg/kg, maximum 50 mg. May repeat once after 15 minutes.
IN
1 mg/kg, maximum 100 mg. The procedure does not list an IN repeat dose.
Pediatric
Age younger than 15 is a contraindication in PR-70. No pediatric analgesia dose is supplied by this OCEMS procedure or I-20.
Do not extrapolate these doses to a child. Use an authorized pediatric analgesia pathway and base direction.
Pediatric dosing availability
PR-70 excludes patients younger than 15. No OCEMS pediatric analgesia dose is provided.
Weight
OCEMS pediatric dose
Any weight
No general pediatric dose under the cited source; follow the applicable order / medical direction.
Preparation & reassessment
Concentration is determined by the provider agency; confirm route-appropriate stock before drawing up the dose.
Record weight, indication, pain before/after, intoxication assessment, response, and ongoing vital signs, SpO₂, consciousness, and cardiac rhythm. Watch for dissociation, tachycardia, or hypertension.