If a casualty is in respiratory distress and experiencing moderate to severe pain, which analgesic is appropriate?

In situations where a casualty is experiencing respiratory distress along with moderate to severe pain, the selection of an appropriate analgesic is crucial to ensure both effective pain management and patient safety. Ketamine, at a dose of 50 mg IM, serves as an effective analgesic because it provides both pain relief and acts as a dissociative anesthetic, which can be beneficial in managing severe pain.

The use of 50 mg IM is typically considered effective for moderate to severe pain while also having a relatively quick onset. In this context, Ketamine’s dissociative properties can help manage not just the pain but also reduce the anxiety and distress that often accompany such situations. The IM route helps in quicker absorption compared to oral administration, which is advantageous in an emergency setting.

While the other options, such as Morphine and Fentanyl, are known analgesics, they can have significant respiratory depressant effects, particularly if the casualty is already in respiratory distress. Thus, they may not be the safest choice under these circumstances. Ketamine, with its unique properties and safer profile regarding respiratory function, makes it a more suitable option in this scenario.