Analgesia and Sedation Management During Prolonged Field Care

Purpose

This Role 1, prolonged field care (PFC) guideline is intended to be used after Tactical Combat Casualty Care (TCCC) Guidelines, when evacuation to higher level of care is not immediately possible. A provider of PFC first must be an expert in TCCC. The intent of this guideline is to identify potential issues one must consider when providing analgesia with or without sedation for an extended time (i.e. 4–72 hours). As a principle, the guideline attempts to decrease complexity by reducing options for monitoring, medications, and so forth. It prioritizes experience with a limited number of options rather than providing recommendations about many different options that can be used in a more customized way. It does not address induction of anesthesia before airway management (i.e. rapid sequence intubation). The CPG should be used by all clinicians providing analgesia and sedation in a Role 1 (R1) or PFC environment.