looking for cites for subQ morphine in peds

[outlierrn]

When I worked peds ER we had lots of kids with ortho pain come in. We often gave subQ morphine, got the films, decided if they needed an IV and proceeded with definitive care. Now I work adult ER and find the docs resistent to this; usually I hear that we should only stick them once. Well, if you figure that it might take 3 tries to get a line on a wrestling kid with an unstabilized fracture or a kid that won't need a line in the long run all the while delaying the X-ray, I miss the old way. I'm wondering if anyone else has had this experience and if you can direct me to any research supporting or criticizing subQ morphine for acute pain in peds. All I can find is research for subQ infusions for oncology pts, which is cool, but not useful for me, thanks

Larry

[TazziRN, RN]

Can you try to get a copy of the P&P at the peds ER where you used to work? I can understand the nervousness of the docs you're with now. A couple of years ago we had a nurse work with us who came from a pedi ER, and some of the stuff she wanted to do sent our eyebrows to the ceiling until we found the stuff she was suggesting was actually the norm in a pedi ER. When you don't specialize in peds those little guys can be scary!

[janejoeben]

Just wondering....do you not use oral morphine?? We (am in UK!) would use that by choice for the paed nasty fractures etc..