Randomized Clinical Trial Comparing a Patient-Driven Titration Protocol of Intravenous Hydromorphone With Traditional Physician-Driven Management of Emergency Department Patients With Acute Severe Pain

The 1+1 hydromorphone patient-driven protocol is statistically superior and at least as clinically efficacious and safe as traditional physician-driven treatment of ED patients with acute severe pain. More than 9 of 10 patients randomized to the study protocol achieved satisfactory pain control, as defined by the patient, within an hour or less.