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Emergency Medicine International
Volume 2012 (2012), Article ID 476161, 5 pages
Research Article

Prehospital Medication Administration: A Randomised Study Comparing Intranasal and Intravenous Routes

1Centre for Emergency Medical Science, University College Dublin, Dublin, Ireland
2Medical Advisory Group of the Pre-hospital Emergency Care Council in Ireland, Naas, Ireland

Received 3 April 2012; Revised 5 June 2012; Accepted 11 June 2012

Academic Editor: Oliver Flower

Copyright © 2012 Cian McDermott and Niamh C. Collins. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Opioid overdose is an ever-increasing problem globally. Recent studies have demonstrated that intranasal (IN) naloxone is a safe and effective alternative to traditional routes of naloxone administration for reversal of opioid overdose. Aims. This randomised controlled trial aimed to compare the time taken to deliver intranasal medication with that of intravenous (IV) medication by advanced paramedic trainees. Methods. 18 advanced paramedic trainees administered either an IN or IV medication to a mannequin model in a classroom-based setting. The time taken for medication delivery was compared. End-user satisfaction was assessed using a 5-point questionnaire regarding ease of use and safety for both routes. Results. The mean time taken for the IN and IV group was 87.1 seconds and 178.2 seconds respectively. The difference in mean time taken was 91.1 seconds (95% confidence interval 55.2 seconds to 126.9 seconds, P0.0001). 89% of advanced paramedic trainees reported that the IN route was easier and safer to use than the IV route. Conclusion. This study demonstrates that, amongst advanced paramedic trainees, the IN route of medication administration is significantly faster, better accepted and perceived to be safer than using the IV route. Thus, IN medication administration could be considered more frequently when administering emergency medications in a pre-hospital setting.