title: Factors associated with delay to opiate analgesia in emergency departments.
abstract: Patients presenting to an emergency department (ED) with painful conditions continue to experience significant delay to analgesia. It remains unclear whether demographic and clinical factors are associated with this outcome. The objectives of this study were to determine 1) the proportion of patients that require parenteral opiate analgesia for pain in an ED and who receive the opiate in less than 60 minutes; and 2) whether any factors are predictive for the first dose of analgesia being delayed beyond 60 minutes. A retrospective cohort study with descriptive and comparative data analysis was conducted. Over a 3-month period, the medical record of every patient receiving parenteral opiates in a tertiary emergency department was reviewed and analyzed. Of 857 patients, 451 (52.6%) received analgesia in less then 60 minutes. Multiple demographic and clinical factors are associated with statistically significant delay to analgesia, including age, triage code, seniority of treating doctor, diagnosis, and disposition from the ED.
  
  
  CONCLUSIONS
  A considerable proportion of patients suffer delay to analgesia. Identifiable factors associated with a delay to analgesia exist. There is potential for clinicians to develop strategies to address the population in emergency departments at risk for delay to analgesia.
authors.affiliation: Department of Emergency Medicine, St. George Hospital, Kogarah, Australia. glenn.arendts@sesiahs.health.nsw.gov.au
authors.forename: Glenn
authors.initials: G
authors.lastname: Arendts
authors.forename: Margaret
authors.initials: M
authors.lastname: Fry
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D042241:Early Diagnosis; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D004638:Emergency Treatment / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy*; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014218:Triage / Q000592:standards / Q000706:statistics & numerical data
chemical_list: D000701:Analgesics, Opioid