An essential element of safe monitoring

The prompt treatment of pain and the control of seizures are essential parts of paramedic practice. This has resulted in paramedics, in many parts of the world, being empowered to administer opiate analgesia and benzodiazepines. These drugs are increasingly being supplemented by Ketamine—both as an analgesic agent, as well as for its sedatory properties.

While these drugs are deemed to be safe for pre-hospital administration, their use does represent a risk of drug-induced respiratory depression. This has resulted in a number of ambulance services also providing reversal agents such as Naloxone (primarily provided for reversal of recreational over-dose) and Flumazenil for use in iatrogenic-induced respiratory depression. However, these drugs are not without side-effects—most notably, the reversal of the analgesic effects of opiates and blocking the anti-convulsion properties of benzodiazepines. Regardless of whether reversal agents are required, their use would still require that the paramedic can accurately identify that respiratory depression has occurred.