Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Pain management and postoperative carePaediatric Intravenous Morphine Algorithm• Check prescription is clear.• Double check dose calculation.• Check naloxone is prescribed• IV morphine should only be used when oral is not available• Check strength of ampoule carefully. A range is stocked from1mg in 1mL up to 60mg in 1mL.• Always dilute dose to 10mL with Sodium Chloride 0.9%.• Note that the peak effect of an I.V morphine dose may not occurfor over 15minutes.• Patients should be monitored closely with vital signs recordedevery 5 minutes for 30 minutes following the I.V dose.Step 1Pain score = 2 or 3Sedation = 0 or 1Respiration rate:• greater than 25 if less than 1 year• greater than 20 if 2-5 years• greater than 16 if 5-12 years• greater than 12 if over 12 yearsS pO 2 ≥ 95%If NO to any of these, do not proceed to STEP 2 but seek medicaladvice.106 Anaesthetists Handbook January 2010