Exclusives
FacebookTwitterLinkedInGoogle+RSS Feed
Fire EMSEMS TodayEMS Insider

Analgesia in Children

Review of: Borland M, Jacobs I, King B, et al: "A randomized controlled trial comparing intranasal fentanyl to intravenous morphine for managing acute pain in children in the emergency department." Annals of Emergency Medicine. 49(3):335-340, 2007

The Science

This study was a double-blind placebo controlled comparison of IV morphine versus intranasal fentanyl to provide analgesia in children with obvious long bone injuries. The dose of morphine and fentanyl was 0.1 mg/kg and 1.7 mcg/kg respectively.

They found no significant difference in visual analogue pain scores at five, 10, 20 or 30 minutes after administration. The authors therefore concluded that intranasal fentanyl is equivalent to intravenous morphine in these subjects.

The Street

Pain management should be a primary concern not only for the emergency department (ED) but for EMS as well. Previous studies have shown that EMS, even with IV morphine, fails miserably in providing analgesia to children. I suspect this failure is based on a reluctance of starting an intravenous line in terrified, young patients due to its inherent difficulties.

With the increased use of fentanyl by EMS - and the knowledge provided by this study - hopefully someone will study the feasibility of providing intranasal fentanyl to injured children. While intranasal administration of fentanyl is not FDA approved, that shouldn't stop us from exploring the appropriateness of its use. Our patients, young and old, deserve pain relief. That is the number one reason they call us, isn t it?

RELATED ARTICLES

Where in the World of EMS is A.J. Heightman?

You cant get there from here.

Reflecting on 35 Years of Innovation in JEMS

Take a walk through the last 35 years of EMS in JEMS.

Pro Bono: Documenting Patient Refusals

Obtaining a signature is only the start of accepting refusal.

The Reasons Why EMS Systems Go Astray

Normalization of deviance doesn’t happen overnight.

Thorough Assessment is Crucial in Patients with Respiratory Distress

Accurate observation and treatment go a long way when considering all causes of respiratory distress.

Training, Practice, Research Lead to Successful Airway Management

Knowing how to correctly intubate a patient is only half the battle.

Features by Topic

JEMS Connect

CURRENT DISCUSSIONS

 
 

EMS BLOGS

Blogger Browser

Today's Featured Posts

Featured Careers