Ketorolac Administration – IV
As indicated in the Advisory Operations 2014 – 07 (See below – also downloadable), while the label on Ketorolac vial indicates the medication is for intramuscular (IM) use only (Figure 1), Sunnybrook Regional Base Hospital (SRBH) advised that Advanced Care Paramedics could continue to administer the drug both IM/IV per their medical directives.
With the introduction of Primary Care Paramedic Autonomous IV in TPS, all levels of Paramedics at Toronto Paramedic Services are permitted to administer Ketorolac from these vials via the intravenous route, in accordance with the Advanced Life Support Patient Care Standards, if certified to do so.
If you have any questions, please contact your Superintendent.
Sincerely,
Morgan Hillier MD, MSc, FRCPC
Base Hospital Medical Director
Toronto Paramedic Program
April Hugh
A/Commander, Education & Development
Toronto Paramedic Services
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Ketorolac Administration – IV memo
CHANGES IN KETOROLAC AND NALOXONE VIALS
Toronto Paramedic Services has recently received a supply of Ketorolac and Naloxone that have
changed in appearance, the concentration remains the same.
Please note the changes below:
KETOROLAC
Ketorolac has remained in amber vials, however the labels have changed from a blue/purple/white label to a white/red/beige coloured label. The blue stopper and the clear plastic cap have also been replaced with a grey cap.
Also note that the label of the new Ketorolac indicates for Intramuscular Use. In consultation with Sunnybrook Regional Base Hospital, they advise that ACP Paramedics can continue to administer the drug IM/IV as has been the previous practice for both in-hospital and pre-hospital administration.
Note the differences in the Ketorolac vials
NALOXONE
Naloxone has also remained in amber vials, however the label colour has changed from a yellow/white/red colour to a white and red colour. The yellow plastic cap has also changed to a blue cap.
Note the differences in the Naloxone vials
Please continue to be diligent in checking your medications during vehicle checks and prior to patient administration. Both new and old vials will remain in circulation until such time as vials are used and or replaced due to expiry.
If you have any questions, please speak to your Superintendent.
(original signed by)
Joe Moyer
A/Deputy Chief
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ADVISORY 2014-07 – Changes in Ketorolac & Naloxone Vials – memo