Inhaled vs IV Opioid Dosing for the Initial Treatment of Severe Acute Pain in the Emergency Department

Exclusion Criteria

• •Chronic pain (\> 3 months)
• •Taking opioids longer than 10 days (including "weak" opioids tramadol and / or codeine);
• •Taking Rifampicin;
• •Impaired ability to discern, cognitive impairment;
• •Morphine-related contraindications:
• •O Obstructive chronic obstructive or restrictive respiratory failure known or suspected compensated or not, O Hypersensitivity to the active substance or to any of the excipients, O Severe hepatocellular insufficiency (known or suspected), O Chronic renal failure known or suspected, O Uncontrolled epilepsy, O Cranial trauma (intracranial hypertension), O Associations with buprenorphine, nalbuphine, pentazocine and naltrexone
• •Active drug history or practice (s);
• •Evidence of reduced fracture or dislocation in emergency rooms;
• •Suspected occlusive syndrome
• •SaO2 \<95%;
• •FR \<12 / min;
• •Glasgow \<15 or other alertness disorders;
• •HR heart rate \<50 bpm and / or Auriculo-Ventricular block (PR XML File Identifier: zR6XOYKSEQ9GjQHghP8c465EwF0= Page 15/30 interval\> 200 ms);
• •Arterial hypotension with systolic blood pressure TA syst \<100 mm Hg;
• •Pregnant or nursing
• •Persons deprived of their liberty by an administrative or judicial decision, a person placed under the safeguard of justice, guardianship;
• •Patients with poor comprehension of spoken or written French;
• •Patients participating in another interventional clinical study;
• •Contra-indication related to the use of saline solution
• •Contra-indications related to the use of aerosol:
• •O Necessity to access the face O Allergy known to plastic