Time to analgesia with early involvement of the Emergency Medicine pharmacist in trauma callouts: a randomised trial (Study Protocol)

INTERVENTION: Early Emergency Medicine Pharmacist involvement in trauma callouts. In the intervention arm the EM pharmacist will attend a trauma call pre‐arrival or on arrival of the patient at bedside in the emergency department. The will be involved in the initial assessment of the patient and assist with appropriate medication ordering and administration, with a focus on early analgesic administration within 30 minutes of patient arrival in the emergency department. This intervention is estimated to take between 20‐30 minutes. To monitor adherence the scribe in the trauma callout will have a standardised form to complete for both standard care and intervention arms which will be provided to the principle investigator. The research team will be monitoring progress through the regular auditing of medical records for patients recruited. CONDITION: Emergency medicine ‐ Other emergency care Emergency medicine ‐ Resuscitation Public Health ‐ Health service research Trauma; ; Trauma PRIMARY OUTCOME: Time to first dose analgesia determined as time first dose of analgesia is signed for on the medication record.[Time from ED registration to first dose of analgesia] SECONDARY OUTCOME: Activation of massive transfusion protocol assessed from retrospective review of electronic medical records[assessed for the duration of time patient is present in the ED] Compliance with local and or national antimicrobial/tetanus vaccine prophylaxis determined retrospectively from the electronic medical records.[Assessed for duration of management in the ED ; ] Drugs and doses used for; sedation, analgesia and RSI, raised ICP in TBI, seizure prophylaxis, reversal of anticoagulation and haemostasis assessed from retrospective review of electronic medical records[Assessed for the duration of time medications ordered and administered in the ED.] Pain scores on arrival, at 30 mins and 60 mins post arrival in ED as documented in the electronic medical records[Time from ED registration to first pain score documentation, documentation at 30 mins and 60 mins post arrival in the ED] Time to sedation and analgesia for intubated patients as signed for on the medication records[Time from patient ED registration to first sign off of analgesia and sedation most intubation in the ED assessed at one timepoint only in the ED] Time to verbal request of analgesia as documented by data collector ; ; ; [Time from patient ED registration to verbal request of first analgesia in the ED by an emergency clinician (physician or registrar) assessed at one timepoint only in the ED. ; ] INCLUSION CRITERIA: All patients presenting to The Alfred Emergency and Trauma Centre meeting trauma callout criteria.