What is an alternative to OTFC if IV access has been obtained?

Intravenous (IV) Morphine is an effective alternative to On-Scene Transmucosal Fentanyl Citrate (OTFC) when IV access has been successfully established. Morphine is a potent opioid analgesic that provides rapid pain relief, making it suitable for treating moderate to severe pain, particularly in tactical combat situations where prompt management of pain is crucial.

Once IV access is obtained, the administration of morphine allows for more controlled dosing and the ability to titrate the medication according to the patient’s response. This method can be beneficial in maintaining pain management throughout the treatment process.

In contrast, the other options present less effective alternatives or are not ideal for immediate pain management in a trauma scenario. Oral Hydromorphone, although an opioid, would not be the first choice in an emergency setting due to its delayed onset of action compared to IV Morphine. Subcutaneous Fentanyl can be used but is typically not as preferred in scenarios where immediate relief is required. IM Ketorolac serves as a non-steroidal anti-inflammatory drug (NSAID) and, while effective for certain types of pain, it does not handle severe pain to the same extent as an opioid does and lacks the rapid onset provided by IV Morphine.