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Fire Commission approves $218,447 grant for prehospital pain‑medication study
Summary
The San Francisco Fire Commission voted to authorize the San Francisco Fire Department to accept and expend a $218,447 grant to join a Department of Defense–linked study comparing fentanyl and ketamine for severe traumatic pain; the grant is retroactive and will operate on a reimbursement basis.
The San Francisco Fire Commission on Feb. 26 approved a retroactive grant enabling the San Francisco Fire Department to participate in a multistage medical study comparing fentanyl and ketamine for prehospital trauma pain.
Director of Finance Mark Corso told the commission the department had been awarded $218,447 “to participate in a study comparing pain medications and trauma,” with funding routed through the Department of Defense, the University of Pittsburgh and the Regents of the University of California, San Francisco before reaching the department. Corso said the city would be reimbursed for training and study enrollment costs; no funds have yet been received.
The study — described at the meeting by Deputy Chief Peng as the PAIN Study, a “prehospital analgesia interventional study” — is a randomized, double‑blind trial funded through Defense Department streams to compare opioid analgesia (fentanyl) against ketamine for people in severe traumatic shock. Peng said the study will examine whether pain is relieved, what the outcomes are and “what will be the drops in blood pressure for these patients.” He also said the study will rely on an exception to standard informed consent rules for patients in critical trauma situations.
Corso and Peng said some preparatory work and training have already taken place but that the department has not received grant funds because federal and sub‑grantee paperwork delayed a contract from UCSF. Corso said the department has trained staff and will submit documentation for reimbursement after the grant is finalized. Peng said the department “trained about 350 paramedics on how to conduct this study last year” and estimated San Francisco would enroll patients meeting strict shock criteria; he said enrollment could be slow and estimated a target in the dozens rather than hundreds.
Commission President Marcy Frazier called for public comment (none was offered) and a motion to approve the resolution. After a motion and second, President Frazier voted “aye” and Commissioner Steven Nakajo recorded a vote of “aye.” The commission announced the motion passed and the department may now move forward with the administrative steps needed to finalize the agreement and claim reimbursement for eligible costs.
Why it matters: The study could affect which analgesic emergency medical personnel choose for certain severe trauma patients, and it involves a controlled, randomized protocol that alters standard prehospital medication practice under statutory exceptions for emergency research. San Francisco’s participation will require training, documentation for federal reimbursement and ongoing oversight from the department’s medical director and UCSF collaborators.
What’s next: The item will proceed to the Board of Supervisors for final authorization and signature by the fire chief, after required city‑attorney language is incorporated into the agreement. The department said it will not receive payment until the agreement is fully executed and reimbursements are processed.
