Breakthrough targets children’s pre-hospital pain

Pain relief: paramedics will use intranasal methods.

Pain relief: paramedics will use intranasal methods.


The administration of groundbreaking new pain-relief medication to children by advanced paramedics is expected to significantly improve the care for sick children in Ireland.

Research funded by the Children’s Medical and Research Foundation through the National Children’s Research Centre (NCRC) in Crumlin found that out of almost 2,500 children transported by ambulance to emergency departments in Ireland over a 12-month period, two-thirds had suffered moderate to severe pain. However, less than half had their pain managed appropriately before arrival at emergency.

The NCRC identified a variety of barriers to the pre-hospital management of acute pain in children, which led to the introduction of revised clinical practice guidelines for pre-hospital practitioners.

The guidelines include the use of intranasal fentanyl as an alternative to oral/intravenous morphine prior to arrival at hospital. The ease of application through a nasal spray allows paramedics to overcome traditional hurdles.

An online module has been developed to deploy these guidelines nationally. Pain is the most common symptom in the emergency setting with adults twice as likely to receive appropriate pain relief as children.