Tom Edward Mallinson
Journal of Paramedic Practice, Vol. 9, Iss. 12, 01 Dec 2017, pp 522 - 526

Non-steroidal anti-inflammatory drugs (NSAIDs) can be used as part of a
multimodal approach to managing acute pain. Administering NSAIDs by
intramuscular (IM) or intravenous (IV) injection allows them to be used in patients
who are nil-by-mouth, who cannot swallow, and to allow a more rapid onset
compared to the oral route. Current paramedic practice in the UK does not
generally allow for the use of an NSAID given by IM or IV injection for acute
pain. While paramedics may administer paracetamol and morphine intravenously,
the only option for an NSAID is oral ibuprofen, or rarely oral naproxen or rectal
diclofenac. Ketorolac is an NSAID, which can be administered by IV or IM injection.
It is an effective analgesic agent when used alone, or in conjunction with other
agents as part of a multimodal approach to analgesia. This article reviews the
evidence from peer-reviewed papers and current clinical guidelines surrounding the
safety and efficacy of ketorolac as an analgesic agent for acute pain, and discusses
its potential use in UK paramedic practice.

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