SARASOTA COUNTY, Fla. — The Sarasota County Fire Department has adopted a new approach to pain management in the field, making intravenous acetaminophen the first-line medication for moderate to severe pain and removing opioids from front-line apparatus.
Department officials stated on social media that the change is aimed at improving patient-centered care while reducing reliance on opioids. Under the updated protocol, paramedics will use IV acetaminophen as an initial treatment option for qualifying patients, reserving opioids for situations where they are clinically necessary under appropriate oversight.
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The department cited research and national guidance indicating that pain can be undertreated before patients reach the hospital due to concerns about opioid side effects and operational barriers. The department also pointed to studies and the National Association of EMS Physicians guidance suggesting IV acetaminophen can provide pain relief comparable to IV opioids, while avoiding respiratory depression and other opioid-related risks.
Should IV acetaminophen replace opioids as a first-line option for moderate to severe pain in the prehospital setting? Why or why not?
