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

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.