BMJ 2001;322:1367 ( 2 June )

Letters

Nasal diamorphine in children with clinical fractures

    Patients should be told what to do when analgesia wears off
    Most interesting questions remain unanswered in this study
    Authors' reply

Patients should be told what to do when analgesia wears off

The first 150 words of the full text of this article appear below.

EDITOR---Kendall et al report the advantages of nasal diamorphine.1 When my 5 year old son was recently admitted to an accident and emergency department with a fractured collarbone, nasal diamorphine was administered with all of the good effects that the authors described. But the effects wear off quite quickly. In our case, diamorphine was administered at 6 am and my son was supplied with a piece of triangular cotton and discharged home.

By 10 am he was in severe pain, and for the following 12 hours or so he was extremely distressed. The combination of ibuprofen and paracetamol prescribed by the hospital was not adequate. When I rang the general practitioner to request something more effective I was told that she could not help; if we had a problem we should take him back to hospital. Even had I been able to face another six hour wait in the accident and emergency . . . [Full text of this article]
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Relevant Article

Multicentre randomised controlled trial of nasal diamorphine for analgesia in children and teenagers with clinical fractures
Jason M Kendall, Barnaby C Reeves, and Victoria S Latter
BMJ 2001 322: 261-265. [Abstract] [Full Text] [PDF]

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