1. Mater Emergency Research in Children and Youth Pharmaco-governance of INF use in children in QLD Emergency Departments Amie Lloyd-Jones 4 th Year BPharm Student

2. Mater Children’s ED Research Clinic [date] Presenter introduction –4 th year pharmacy student at UQ –Here on a 4 week university placement –Placement has a QUM focus Promote and contribute to the quality use of medicines Short Title

3. Mater Children’s ED Research Clinic [date] Children in pain receive less analgesia than adults –Communication barrier –Lack of evidence-based medicine IV morphine – gold standard for strong pain in children IN fentanyl – alternative to IV morphine (no needles!) Fast, safe and effective pain relief without the need for IV access Background

4. Mater Children’s ED Research Clinic [date] RCT – Borland et al 2007 Demonstrated IN fentanyl = IV morphine –No significant difference in analgesic effect or time to analgesia IN fentanyl use is off-label and off-licence –Not commercially formulated for IN use Background

5. Mater Children’s ED Research Clinic [date] Aims Characterise the pharmaco- governance of intranasal fentanyl in Queensland Emergency Departments having at least 1000 paediatric attendances per annum

6. Mater Children’s ED Research Clinic [date] Researchers Dr David Herd Aaron Basing Amie Lloyd-Jones

7. Mater Children’s ED Research Clinic [date] Study method Participants – QLD Emergency Departments with ≥1000 paediatric attendances in 2009 5 minute phone interview –Is INF used & main indications –Can nurses initiate –Does policy exist –Inclusion/exclusion criteria and doses

8. Mater Children’s ED Research Clinic [date] Results (so far...) Outcomes –Primary Power –Secondary

9. Mater Children’s ED Research Clinic [date] Discussion points Most Qld Emergency Departments use IN fentanyl Majority have policy/procedure documents for use –Ideally want all to have standard policy –Include more thorough dosing guides Very few have nurse initiation –Some are moving towards this –Potential to reduce time to analgesia