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Field medications · Adult & pediatric guidance · ALS

Ketorolac (Toradol)

Non-opioid analgesia with strict age, renal, bleeding, and pregnancy exclusions.

OCEMS source summary · Updated 2026-09-16

Check before giving

  • Do not give above age 65, for suspected cardiac pain, NSAID hypersensitivity, renal disease/transplant, pregnancy/suspected pregnancy, or breastfeeding.
  • Exclude active ulcer disease, GI bleeding/perforation within 3 months, trauma-center designation, active/high-risk hemorrhage or coagulopathy, recent major surgery within 6 weeks or planned major surgery, and concurrent NSAID/anticoagulant use. PR-075 makes an exception for low-dose aspirin.

Use in OCEMS

  • For moderate–severe pain (4–10), as an alternative or adjunct to an opioid when PR-075 criteria are met.
  • Examples include opioid intolerance/refusal, moderate pain where opioids may not be appropriate, inability to obtain IV access, or additional analgesia after fentanyl.

Adult / adolescent

Indication / routeDose & limits
Eligible adults15 mg IV/IO/IM once. IV is preferred when a line is present.

Pediatric

  • For eligible children age 2 and older: 0.25 mg/kg IV/IO/IM once, maximum 15 mg.
  • Age below 2 is a contraindication. Use measured weight in kilograms and record it.

Pediatric weight table — Pain — age 2 and older only

  • Source: PR-075. Dose rule: 0.25 mg/kg; route: IV/IO/IM once.
  • Age 2 and older: 0.25 mg/kg IV/IO/IM once; maximum 15 mg. Children younger than 2 are excluded regardless of weight.
  • Check all PR-075 exclusions, including renal disease, bleeding risk, designated trauma, recent GI bleeding, NSAID allergy/use, pregnancy, and breastfeeding. Weight alone does not establish eligibility.
  • Calculated examples for the exact weights shown, using the named standing-order/procedure formula. Do not round the patient’s weight to the nearest row. For another weight, calculate from the stated formula and apply the limits. These are not the rounded I-20 weight-band volumes.
  • Volumes are mathematical examples rounded to at most three decimal places. Verify the vial concentration, dose, and measurable syringe volume before administration; follow agency preparation/rounding practice.
Exact weightDose — IV/IO/IM onceVolume at 15 mg/mL
3 kg0.75 mg0.05 mL
4 kg1 mg0.067 mL
5 kg1.25 mg0.083 mL
6 kg1.5 mg0.1 mL
8 kg2 mg0.133 mL
10 kg2.5 mg0.167 mL
12 kg3 mg0.2 mL
15 kg3.75 mg0.25 mL
20 kg5 mg0.333 mL
25 kg6.25 mg0.417 mL
30 kg7.5 mg0.5 mL
35 kg8.75 mg0.583 mL
40 kg10 mg0.667 mL
45 kg11.25 mg0.75 mL
50 kg12.5 mg0.833 mL
60 kg15 mg1 mL

Preparation & reassessment

  • The inventory concentration is 15 mg/mL. Verify the ordered milligrams and volume; the dose is not 15 mg/kg.
  • Document indication, exclusion screening, baseline pain, pediatric weight, response, and any adverse reaction.