Association between access block and time to parenteral opioid analgesia in renal colic: A pilot study

Chu, Kevin and Brown, Anthony (2009) Association between access block and time to parenteral opioid analgesia in renal colic: A pilot study. Emergency Medicine Australasia, 21 1: 38-42. doi:10.1111/j.1742-6723.2008.01146.x


Author Chu, Kevin
Brown, Anthony
Title Association between access block and time to parenteral opioid analgesia in renal colic: A pilot study
Journal name Emergency Medicine Australasia   Check publisher's open access policy
ISSN 1742-6731
1742-6723
Publication date 2009-02
Sub-type Article (original research)
DOI 10.1111/j.1742-6723.2008.01146.x
Volume 21
Issue 1
Start page 38
End page 42
Total pages 5
Editor Brown, Anthony F.
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2010
Language eng
Subject C1
920204 Evaluation of Health Outcomes
110305 Emergency Medicine
Formatted abstract
Objective: To seek an association between access block and time to parenteral opioid analgesia (POA) in ED patients presenting with renal colic.
Methods: Renal colic patients given POA were retrospectively identified over 3 months. Time of administration of POA was abstracted from patients’ charts. Access block data, time of arrival and demographics were retrieved electronically. A logistic regression was used to seek an association between time to POA (dichotomized into <1 h and >1 h of arrival) with daily access block (proportion of patients requiring hospital admission in a 24 h period who have a total ED time >8 h, dichotomized at its median), time of administration of POA (00.00–07.59 hours [T1], 08.00–15.59 hours [T2], 16.00–23.59 hours [T3] ), age and sex.
Results: Of 69 patients, 42 (60.1%, 95% CI 51–70%) received POA within 1 h. Access block occurred daily (median 28.8%, range 6.8–53.1%). Mean hourly ED attendance rates for all patients during T1, T2 and T3 were 4.0, 11.7 and 7.8 patients/h respectively. As predictors of time to POA (>1 h vs 1 h), the adjusted OR for access block (29% vs <29%) was 1.0 (95% CI 0.4–2.9), T3 versus T2 was 5.0 (95% CI 1.4–17.7), T1 versus T2 was 1.0 (95% CI 0.3–23.8), age (47 years vs <47 years) was 0.8 (95% CI 0.3–2.3) and for sex (female vs male) was 0.4 (95% CI 0.1–1.6).
Conclusion: Time to POA was related to time of administration, but not to access block. Access block might be too crude a measure to quantify ED overcrowding, and so its influence on time to POA may not be exhibited.
Keyword Access block
Crowding
Emergency department
Overcrowding
Time to analgesia
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 21 Apr 2010, 15:41:51 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH