Factors influencing prehospital and emergency department analgesia administration to patients with femoral neck fractures

Objectives: To assess the analgesia practices of ambulance personnel and emergency department staff treating patients with fractured neck of femur. Methods: This is a retrospective analysis of 176 patients with an admission diagnosis of fractured neck of femur, who presented to a major western Sydney teaching hospital, between January and November 1999. Results: One hundred and twenty-eight patients met the inclusion criteria. The median age was 82, there were more female than male subjects. Ambulance officers made a clinical diagnosis of fractured neck of femur in 68% of cases. In 49% of cases no analgesia was given. Patients were given a higher triage category and pain relief faster if they had been given analgesia by ambulance officers, P = 0.0018 and P = 0.002, respectively. The median time to analgesia was 2 h 48 min. Conclusions: Only a modest proportion of patients with fractured neck of femur received prehospital analgesia and delays to analgesia in the emergency department are considerable. Strategies to address the delivery of appropriate analgesia to this group of patients should be developed.