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Paediatric prehospital fentanyl: serious adverse effects rare
Is prehospital opioid administration safe in children? A register-based study
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine · 2026-11-05 · Added 7 November 2026
A Danish register study of 1,531 children given prehospital opioids (99.7% fentanyl) found 15.1% had at least one clinical sign compatible with opioid adverse effects, serious signs were uncommon (bradycardia and respiratory depression 0.7% each), and 63.6% were still in pain at hospital arrival.
- Study type
- Registry
- Design
- Retrospective register-based cohort with medical record review
- Participants
- 1,531 children aged 0–14 given prehospital opioids, Denmark 2017–2022
- Main finding
- 15.1% had at least one clinical sign compatible with opioid-related adverse effects; bradycardia 0.7%, respiratory depression 0.7%; no opioid antidote given; 63.6% in pain at arrival and 51% received further in-hospital analgesia.
- Caveat
- Retrospective register review — nonspecific signs such as nausea and drowsiness can't be firmly attributed to opioids (no other explanation identified in 9.2%).
- Bottom line
- Supports current practice
Why it matters in Australia (High relevance). Fentanyl is standard prehospital analgesia across Australian services, and a national registry like this speaks directly to how crews dose paediatric pain relief.
Learning goal
Refine my assessment and monitoring of prehospital opioid analgesia in paediatric patients to reduce under-treatment of pain.
More
- Topic: Paediatrics
- Daily scan: 7 November 2026
- Podcast: Paramedic Papers Daily, 7 November 2026
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