Time Required for Intranasal and Intravenous Analgesia Administration by Military Nurses in Simulated Trauma Care...

IntroductionTrauma 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.MethodsMilitary 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.ResultsOf 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).ConclusionsAdministration 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.