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Essex & Herts Air Ambulance (EHAAT) is introducing fentanyl “lollipops” to provide faster pain relief for patients at the scene of serious incidents, including those involving multiple casualties.
The move comes as emergency services continue to reflect on lessons from the Manchester Arena bombing, nine years on. The public inquiry into the attack highlighted the need for more rapid access to potent analgesia at the scene, particularly where large numbers of patients require urgent care.
Traditionally, strong pain relief in pre-hospital settings has been delivered via injection. While effective, this method can take time to prepare and administer, particularly in complex or high-pressure environments. EHAAT said the introduction of fentanyl lozenges offers a quicker, more scalable alternative in such scenarios.
The lozenges, which resemble lollipops, contain a high-strength opioid analgesic and are absorbed through the mouth. Once prescribed by clinicians, patients can self-administer the medication by moving it along their gums, allowing pain relief to take effect within minutes.
“It is really important to deliver safe, effective and rapid pain relief and we’re passionate about delivering that for our patients. The lozenges provide a way to do this without requiring waiting for delivery via a vein, especially in situations where we need to help multiple patients at the same time.”
Dr Ali Watts, who led on the project
EHAAT is among a small number of UK air ambulance services now carrying fentanyl lozenges for both routine use and potential deployment at major incidents. The organisation said the approach is particularly suited to situations such as road traffic collisions, stabbings, and large-scale emergencies where multiple patients may be in severe pain.
Dr Gareth Grier, Associate Medical Director at EHAAT, described the development as “a game changer for analgesia during multiple patient events,” adding that it addresses a longstanding need for treatment that is both rapid and easy to administer in challenging conditions.
Fentanyl lozenges are already used in hospital settings, including for conditions such as sickle cell disease, where patients can experience severe pain episodes. EHAAT said the lozenges would typically be used as an initial intervention, with further analgesia and advanced treatments provided as additional resources arrive on scene.
“One of the most important factors reported to us by our patients and their families is how effectively their pain was managed. Taking people out of pain rapidly is one of the most vital roles that air ambulance teams play and it is so important both in the immediate phase and in terms of long-term recovery.”
Alice Kershberg, lead for EHAAT’s patient and family liaison team
Marking the anniversary of the Manchester attack, the charity said it remains focused on strengthening its preparedness for major incidents, while acknowledging the lasting impact on those affected.
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