Podcast 802: Intranasal Medication Administration for Pediatric Patients - The Emergency Medical Minute

Podcast 802: Intranasal Medication Administration for Pediatric Patients

Contributor: Aaron Lessen, MD

Educational Pearls:

  • Intranasal medication administration is a convenient, quick, and relatively painless option for pediatric patients
  • Often used as an initial medication to help control pain in children prior to establishing an IV
  • Using an atomizer is preferred when administering intranasal medications
  • The syringe should be angled towards the ipsilateral eye or occiput rather than straight upwards
  • Do not administer more than 1 mL of fluid per nostril as volumes greater than 1 mL are not sufficiently absorbed
  • Intranasal medication doses differ from the traditional IV dosages and have a slower onset of action


Del Pizzo J, Callahan JM. Intranasal medications in pediatric emergency medicine. Pediatr Emerg Care. 2014;30(7):496-501; quiz 502-494.

Fantacci C, Fabrizio GC, Ferrara P, Franceschi F, Chiaretti A. Intranasal drug administration for procedural sedation in children admitted to pediatric Emergency Room. Eur Rev Med Pharmacol Sci. 2018;22(1):217-222.

Rech MA, Barbas B, Chaney W, Greenhalgh E, Turck C. When to Pick the Nose: Out-of-Hospital and Emergency Department Intranasal Administration of Medications. Ann Emerg Med. 2017;70(2):203-211.

Schoolman-Anderson K, Lane RD, Schunk JE, Mecham N, Thomas R, Adelgais K. Pediatric emergency department triage-based pain guideline utilizing intranasal fentanyl: Effect of implementation. Am J Emerg Med. 2018;36(9):1603-1607.


Summarized by Mark O’Brien, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD


The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account. 

Donate to EMM today!


Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.


Stay up to date by
joining our mailing list!