A survey of intranasal medication use in the paediatric emergency setting in England and Wales

Abstract

For analgesia and sedation in the paediatric setting, intranasal medication is favourable for several reasons, in particular ease of administration and rapid onset of action. A survey was conducted of all Emergency Departments in England and Wales regarding their use of intranasal medication in children. Approximately 50% use intranasal medication, commonly intranasal diamorphine with sporadic use of other opiates. Intranasal midazolam is used for sedation but is less well tolerated than when administered orally. Intranasal diamorphine, however, is safe and effective in the management of pain in the paediatric emergency setting and its ease of administration makes it ideal for use in the already traumatised child.

Goodbye to needles

“…Nasal diamorphine 0.1 mg/kg is used in the UK for forearm fracture pain in the emergency room 3. Nasal sufetanil and ketamine have also been used for paediatric analgesia, but for much of the world fentanyl remains popular for acute and chronic tuning of pain control.…”

Unraveling Pharmacokinetics and Pharmacodynamics in Infants and Children

“…Nasal diamorphine, 0.1 mg/kg, is used in the UK for forearm fracture pain in the emergency room [66][67][68][69], but for the remainder of the world, fentanyl remains the stalwart. Nasal fentanyl (150 mcg/mL) 1.5 mcg/kg given to children (3-17 years) with fracture pain resulted in good analgesia.…”

Intranasal sufentanil/ketamine analgesia in children

“…Intranasal administration provides direct access to the systemic circulation and may be an acceptable route of administration for children . In children, intranasal midazolam , sufentanil , and ketamine have been used for preinduction of anesthesia and combinations of sufentanil/midazolam or ketamine/midazolam for preinduction of anesthesia and postoperative analgesia .…”