Grand Rounds is a monthly blog series developed by EMS World and FlightBridgeED that will feature top EMS medical directors exploring the intricacies of critical care in EMS practice. In this installment FlightBridgeED Chief Medical Officer Jeffrey Jarvis, MD, PM, reviews the drug ketorolac. Unless you’ve been very committed to keeping your head in the sand, you’ve probably noticed we’re in the midst of an opioid epidemic. Though there is little evidence that the one or two doses of IV opioid medications EMS might give for acute pain contribute to opioid misuse, there are other reasons to have multiple analgesia options in our toolbox. Perhaps patients don’t want an opioid because they are in recovery or fear addiction. Maybe a patient had adverse reactions to opioids in the past, or perhaps other types of medications just work better for them. Regardless, it might be time to consider adding an IV nonopioid medication to our protocols.