Cognitive impairment is a risk factor for delayed analgesia in older people with long bone fracture — The Association Specialists
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Cognitive impairment is a risk factor for delayed analgesia in older people with long bone fracture (383)

Margaret Fry 1 , Glenn Arendts 2 , Lynn Chenoweth 3 , Casimir MacGregor 3
  1. NSLHD, Royal North Shore, NSW, Australia
  2. University of Western Australia, Cognitive impairment is a risk factor for delayed analgesia in older people with long bone fracture, Perth, Western Australia, Australia
  3. Faculty of Health, Univeristy of Technology, Sydney, Sydney, NSW, Australia

Background: Older persons who present to the ED often experience a significant delay to analgesia. This study compares the time to analgesia for cognitively impaired and cognitively intact older people diagnosed with a long bone fracture.
Aim: To determine if cognitive impairment is associated with a delayed analgesic response.
Method: A 12 month review was conducted across four emergency departments. A medical record review of 255patients with long bone fractures were randomly sampled for the review.
Results: The majority of patients waited longer than 60 minutes for analgesia. The median time to analgesia for the cognitively intact group was 72 minutes compared with 149 minutes for the cognitively impaired group, with the difference statistically significant. There was a significant difference found between the proportions for cognitively impaired versus intact patients waiting more than 60 minutes.
Conclusion: This study suggests that cognitive impairment is a significant risk factor for delayed analgesia response in the ED. There is potential for emergency clinicians to better utilised targeted pain assessment tools that address needs of older persons with cognitive impairment and enhance pain management responses by clinicians.