To paraphrase Dr. Sergey Motov: when IV access is unattainable or undesirable, nebulized, intranasal and transmucosal administration of analgesics should be considered for acute pain management in the ED. The best evidence is from a systematic review of nebulized fentanyl (see citation).
The doses (off-label use) are: 4mcg/kg for an adult titrated up to three doses. Peds: 2-4mcg/kg. For morphine: 0.2mg/kg peds, 10mg or 20mg adults fixed-dose.
We can use the breath-actuated nebulizer (pic) to ensure patient-controlled dosing. It is located in the pyxis or from pharmacy. If you still don’t know how to use it, ask!
Manufacturer video: https://www.youtube.com/watch?v=7Xk-tYhhEdU
See this article for more information:
Thompson JP, Thompson DF. Nebulized Fentanyl in Acute Pain: A Systematic Review. Annals of Pharmacotherapy 2016, Vol 50(10): 882-891.