Inclusion criteria: | |
• | Ages 1 – 21 years |
• | ≥10 kg and ≤70 kg |
• | Known sickle cell disease presenting with severe pain |
• | Written informed consent, ideally from both parents (and assent, where appropriate), obtained prior to painful crisis (for example, in Haematology clinic) |
• | Verbal consent (and assent, where appropriate) obtained at the time of the painful crisis in the ED |
• | Hospital admission required for painful crisis |
Exclusion Criteria: | |
• | Patient has received parenteral narcotic analgesic within 4 hours of ED presentation |
• | Oxygen saturations below 95% on initial assessment |
• | Altered conscious state as defined by a Glasgow Coma score less than 15 |
• | Contraindications to fentanyl/morphine usage |
• | Inability to secure IV access |
• | Patient has participated in another clinical trial involving an Investigation Medicinal Product (IMP) within 4 weeks of dosing, or is currently enrolled in another clinical trial involving an IMP, or has been previously enrolled in this trial |
• | Patients who have any condition that would make him/her, in the opinion of the Investigator or Sponsor, unsuitable for the study, or who are, in the opinion of the Investigator, not likely to complete the study for any reason |
• | Blocked or traumatised nose |