1. The subcutaneous opioid algorithm may be used in the following areas:

• Children’s ward
• ITU, SHDU, Theatres and Recovery areas.

2. Morphine is the opioid of choice.

3. In the following children, CAUTION should be exercised and the opioid dose should be reduced:

• Children with renal impairment
• Children with liver failure
• Children at risk of airway obstruction

The following children are NOT SUITABLE for the opioid algorithm:

• Children with oedema or poor skin condition at the injection site
• Children with poor peripheral circulation (altered drug absorption)
• Children with head injuries
• Children whose pain is of a chronic non-malignant nature.

4. All children should have patent intravenous access.

5. Nursing staff should be competent in the use of the opioid algorithm and have attended In-service training on its use.

6. All areas must have NALOXONE (0.4mg ampoule) immediately available.

SUB- CUTANEOUS OPIOID ALGORITHM

ALWAYS USE THIS ALGORITHM PRIOR TO ADMINISTERING AN OPIOID