What should be administered for moderate to severe pain if SBP is greater than 100 mmHg and Naloxone is available?

Fentanyl is an effective choice for managing moderate to severe pain, particularly when a patient has a systolic blood pressure (SBP) greater than 100 mmHg. The key reason for selecting Fentanyl in this scenario is its powerful analgesic properties and rapid onset of action, making it suitable for immediate pain relief.

When Naloxone is available, it indicates that there is a plan in place to reverse any potential respiratory depression caused by opioids. This is an important safety measure, especially with potent opioids like Fentanyl. The dosages provided, whether 400 mcg buccally or 100 mcg intranasally, are appropriate for treating significant pain and can be administered quickly and effectively.

In contrast, while Ketamine and Morphine are also effective analgesics, they may not be the first line in this context. Ketamine can be used for pain management, but it’s also a sedative, which may not be necessary if simple analgesics like Fentanyl are effective. Morphine, though a strong opioid, could require closer monitoring for side effects, especially if naloxone is not available. Ibuprofen, while good for mild to moderate pain, does not match the efficacy of Fentanyl