Medic 1: Alright, medication cross-check 

Medic 2:  Ready 

Medic 1: I’m going to give medication for *REASON*. (*hands vial to partner without stating the medication*) Please check: the medication name, concentration, and expiry date. 

Medic 2: This is *MEDICATION NAME*, 10mg in 1 mL, and expiry date is next year, March 2027. (Medic2 hands vial back to Medic1). What are the indications and contraindications for *MEDICATION? 

Medic 1: The patient meets the conditions of *REASON FOR GIVING MEDICATION*; *STATE CONTRAINDICATIONS* 

Medic 2: What is the volume you’re going to draw up? What route?  

Medic 1: I’m going to draw up *STATE VOLUME*, and administer it PO (*shows partner the syringe*). Check: confirm *VOLUME OF MEDICATION*  

Medic 2: I agree that the concentration of *STATE CONCENTRATION*, *STATE VOLUME* is the right volume for an *STATE DOSE AMOUNT* dose. Any concerns before you give it? 

Medic 1: No concerns. I am going to give *STATE DOSE OF MEDICATION, NAME OF MEDICATION, VOLUME OF MEDICATION, REASON FOR GIVING THIS MEDICATION, ROUTE OF MEDICATION*  

Medic 2: Go ahead and give it. Cross-check complete.

• Small, equal parts of the maximum single dose that are administered q 3 minutes until the desired analgesia is achieved or the maximum single dose is reached. Paramedics should document the total amount of a single dose administered and not each individual aliquot as a separate dose.

• An opiate naive individual is someone who has not taken opioids regularly or recently enough to develop tolerance. This can include people who have never used opioids or those who have not used them for a significant period, often defined as 7 to 120 days, depending on clinical guidelines. Because their bodies have not adapted to opioids, even a small dose can produce a strong effect. 

• Paramedics are encouraged to use their clinical judgment when choosing which analgesia is best suited for their patient. 

• Clinical judgement should include weighing the risks and benefits of using the various medications. This includes: previous use, other medications the patient is taking, medical history, event history, current and expected hemodynamic stability. 

• EtCO2, RR, HR, BP, LOA, O2 sats, signs of adverse reactions 

• Yes, it is appropriate to consider utilizing a lower dosing regimen set out in the ALS PCS. Aliquots are also useful in these situations. Paramedics are encouraged to use clinical judgement to promote patient safety. Document all reasoning on ePCR. If unsure, patch to a BHP.