دورية أكاديمية
Safety of nurse-directed triage intranasal fentanyl protocol for acute pain management in a European pediatric emergency department: A retrospective observational analysis.
| العنوان: | Safety of nurse-directed triage intranasal fentanyl protocol for acute pain management in a European pediatric emergency department: A retrospective observational analysis. |
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| المؤلفون: | Romano F; Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland., Wendelspiess M; Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland., Mansour R; Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon., Abplanalp-Marti O; Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland., Starvaggi C; Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland., Holzner F; Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland., Steiner I; Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland., Keitel K; Department of Paediatrics, Division of Paediatric Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland. |
| المصدر: | Frontiers in pediatrics [Front Pediatr] 2023 Feb 13; Vol. 11, pp. 1070685. Date of Electronic Publication: 2023 Feb 13 (Print Publication: 2023). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Frontiers Media SA Country of Publication: Switzerland NLM ID: 101615492 Publication Model: eCollection Cited Medium: Print ISSN: 2296-2360 (Print) Linking ISSN: 22962360 NLM ISO Abbreviation: Front Pediatr Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Lausanne : Frontiers Media SA, [2013]- |
| مستخلص: | Background: Nurse-directed pain protocols for intranasal fentanyl administration are not widely implemented in European (EU) pediatric emergency departments (PED). Barriers include perceived safety concerns for intranasal (IN) fentanyl. The aim of this study is to describe our experience with a nurse-directed triage IN fentanyl protocol with a focus on safety in a tertiary EU PED. Methods: We conducted a retrospective analysis of patient records of children aged 0-16 years who received nurse-directed IN fentanyl between January 2019 and December 2021 at the PED of the University Children's Hospital of Bern, Switzerland. Extracted data points included demographics, presenting complaint, pain score, IN fentanyl dosage, concomitant pain medication use, and adverse events. Results: A total of 314 patients were identified with ages ranging from 9 months to 15 years. The main indication for nurse-directed fentanyl administration was musculoskeletal pain due to trauma ( n = 284, 90%). Mild adverse events (vertigo) were reported in two patients (0.6%), without a correlation to concomitant pain medication or protocol violation. The only reported severe adverse event of syncope and hypoxia in a 14-year-old adolescent occurred in a setting where the institutional nurse-directed protocol was violated. Conclusion: In accordance with previous studies outside of Europe, our data support the case that when appropriately used, nurse-directed IN fentanyl is a safe potent opioid analgesic for pediatric acute pain management. We strongly encourage the introduction of nurse-directed triage fentanyl protocols Europe-wide in order to provide effective and adequate acute pain management in children. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2023 Romano, Wendelspiess, Mansour, Abplanalp-Marti, Starvaggi, Holzner, Steiner and Keitel.) |
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| فهرسة مساهمة: | Keywords: analgesia; intranasal fentanyl; nurse-directed triage protocol; pain management; pediatric emergency medicine; safety |
| تواريخ الأحداث: | Date Created: 20230302 Latest Revision: 20230303 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC9969078 |
| DOI: | 10.3389/fped.2023.1070685 |
| PMID: | 36861074 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2296-2360 |
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| DOI: | 10.3389/fped.2023.1070685 |