Time to analgesia delivery in musculoskeletal trauma care: An observational study

Abstract

Introduction: Timely administration of analgesia is fundamental to emergency musculoskeletal trauma care. Delays contribute to suboptimal outcomes, patient dissatisfaction, and the potential progression to chronic pain.

Objective: This study aims to assess door-to-analgesia time (DTAT) in the emergency department (ED) and to identify factors contributing to delays.

Methods: A prospective observational study was conducted over 5 months, enrolling 90 adult patients with musculoskeletal trauma at an urban tertiary ED. Pain intensity was recorded using a numerical rating scale at triage, pre- and post-analgesia, and discharge. Patients were stratified into Group A (DTAT ≤30 min) and Group B (DTAT >30 min). Statistical analyses were performed to identify predictors of delayed analgesia and to evaluate pain relief efficacy.

Results: The mean DTAT was 40.6 min, with 45% of patients receiving analgesia within 30 min. Older age (>45 years) was a significant predictor of prolonged DTAT (>45 min; p<0.05). No significant differences in DTAT were observed across triage categories (T2: 34.4 min vs. T3: 43.6 min; p>0.05). Analgesia administration led to a 50% reduction in mean pain score; however, DTAT was not significantly associated with patient satisfaction.

Conclusion: Delayed analgesia remains a challenge, particularly among older patients. Strategies such as nurse-initiated analgesia, enhanced triage protocols, and optimized resource allocation may improve DTAT and patient outcomes. Multicenter studies are warranted to validate and refine pain management protocols in ED settings.

Keywords

Musculoskeletal trauma / Pain / Analgesia time / Quality improvement

Funding

None.

Conflict of interest

The authors declare they have no competing interests.

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