Introduction of an Intranasal Diamorphine Pathway for Manipulation of Paediatric Forearm and Distal Radius Fractures in the Emergency Department 

Description

In this presentation, Alex Beveridge discusses a quality improvement project aimed at streamlining services for pediatric forearm and distal radial fractures in the emergency department of the Great University Hospital in Wales. With over 110,000 children in the health board, these fractures are common and typically require only basic realignment for satisfactory outcomes. The initiative focuses on utilizing intranasal diamorphine to reduce the need for general anesthetics, effectively allowing for quicker treatment in the emergency department.



The presentation outlines a retrospective review that indicated potential improvements in patient satisfaction, length of stay, and health board costs, leading to a prospective study where a new protocol was established for manipulating fractures in the emergency room. The study monitored factors like patient satisfaction, pain levels during procedures, and economic savings. Results showed a 100% success rate in adequately reducing fractures without further interventions needed, with high satisfaction scores from parents reflecting their preference for treatment without admission for anesthesia. The study demonstrated significant savings in time and costs without compromising care, aligning the hospital's practices with new national guidelines for pediatric fracture management.

DOI: 10.1302/3114-221716

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