Comparison of the effectiveness of three oral analgesic combinations in adults presenting to the Emergency Department with moderate pain from acute limb injury.

INTERVENTION: Arm 1) oxycodone 10 mg oral tablet with paracetamol 1000 mg oral tablet with ibuprofen 400 mg oral tablet administered simultaneously as a single dose Arm 2) codeine 60 mg oral tablet with paracetamol 1000 mg oral tablet with ibuprofen 400 mg oral tablet administered simultaneously as a single dose CONDITION: analgesia comparative analgesic effectiveness emergency medicine moderate pain PRIMARY OUTCOME: Minimum fall in pain score of at least 20 mm on 100 mm visual analog scale from baseline pain score taken at triage. SECONDARY OUTCOME: Patient ability to indentify drug regimen prescribed to them. Subjects will be asked by a study investigator whether they think they received: ; 1) Paracetamol Ibuprofen and Thiamine ; 2) Paracetamol Ibuprofen and Oxycodone ; 3) Paracetamol Ibuprofen and Codeine Patient satisfaction with analgesia regimen assessed at end of study period by study researcher asking subject the degree of satisfaction on a three point satisfaction scale: 1) satisfied 2) not satisfied 3) unsure Use of rescue analgesia as assessed by lack of fall in pain score on visual analog scale administered by study researcher INCLUSION CRITERIA: 1) Adult patients greater than or equal to18 years old and less than or equal to 75 years old AND 2) Limb injury within the preceding 48 hours AND 3) Initial verbal pain score elicited by the Triage Nurse of greater than 3/10 to less than or equal to 7/10 (ie 4 to 7/10)