For analgesia and sedation in the paediatric setting, intranasal medication is favourable for several reasons, in particular ease of administration and rapid onset of action. A survey was conducted of all Emergency Departments in England and Wales regarding their use of intranasal medication in children. Approximately 50% use intranasal medication, commonly intranasal diamorphine with sporadic use of other opiates. Intranasal midazolam is used for sedation but is less well tolerated than when administered orally. Intranasal diamorphine, however, is safe and effective in the management of pain in the paediatric emergency setting and its ease of administration makes it ideal for use in the already traumatised child.