1+1 hydromorphone protocol

The 1+1 protocol is a patient-driven intravenous hydromorphone titration strategy developed by researchers at Montefiore Medical Center for the management of acute severe pain in emergency department patients. The protocol involves an initial 1 mg dose of IV hydromorphone, followed by a mandatory assessment 15 minutes later. At this interval, the patient is asked, "Do you want more pain medication?" If the patient answers "yes," a second 1 mg dose is administered. This approach is designed to provide efficacious analgesia while allowing for individual variation in opioid requirements and minimizing the risk of over-sedation or respiratory depression. It has been studied in Phase 3 clinical trials, comparing its efficacy and safety against fixed-dose bolus regimens (such as 2 mg IV hydromorphone) and traditional physician-directed care.

Other names

1+1 protocol1 + 1-Montefiore Medical Center-acute painMontefiore 1+1 protocolpatient-driven titration protocol