Time Required for Intranasal and Intravenous Analgesia Administration by Military Nurses in Simulated Trauma Care Scenarios: A Crossover Randomized, Controlled Trial

Introduction Trauma patients often require intravenous (IV) access for analgesia. Alternatively, analgesia can be administered intranasally (IN). This open-label crossover randomized, controlled trial aimed to determine the time required for IV and IN analgesia administration by military nurses in simulated prehospital trauma scenarios. Methods Military nurses completed 2 simulated prehospital trauma scenarios using a high-fidelity mannequin. Each scenario included patient assessment and administration of a simulated analgesic (water for injection). Military nurses administered the simulated analgesic intravenously in the first scenario and intranasally in the second scenario (sequence IV/IN) or vice versa (sequence IN/IV). Primary outcome was the time required for administration of the simulated analgesic. Secondary outcomes included on-scene time and user satisfaction with the route of administration employed. Results Of the 16 participants, 8 were allocated to sequence IV/IN and 8 to sequence IN/IV. Median age was 29 y, and 69% were female. IV administration required significantly more time than IN administration: mean difference 2.9 min (95% CI 2.4–3.4, p <0.0001). On-scene time also was significantly longer for IV administration: mean difference 3.3 min (95% CI 2.5–4.1, p < 0.0001). Median satisfaction scores were 6 (interquartile range 5–7) for IV administration and 9 (interquartile range 8–9) for IN administration. Satisfaction scores were lower for IV administration ( p <0.0001). Conclusions Administration of a simulated analgesic required 2.9 min longer for IV compared with IN administration when performed by military nurses in simulated prehospital trauma care scenarios.