Prehospital Pain management in Children and Adolescents

Both trauma-associated and medical emergency situations in children are often associated with significant pain. Therefore, appropriate pain management is an important clinical issue for emergency medical services (EMS). A number of authors have also documented that children pose significant cognitive and therapeutic challenges for EMS providers. For example, routes of administration, drug dosing, and perceived discomfort with the care of an injured child are all barriers to administration of analgesia in children. A noninvasive route, e.g. rectal or intranasal, is a promising alternative in emergency situations until an intravenous line is achieved. For the intravenous use of analgesics, ketamine, midazolam, and various opioids are available.