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An alternative to opioids is desirable. Oral medications are not feasible with gastrointestinal disorders or NPO. Intravenous medications require skill and time. Intravenous\/intramuscular medications are painful with potential needlestick injury. Intranasal medications have rapid onset, easy administration, do not need skilled providers, and no risk of needlestick injury. A total of 28 adults with acute pain (numeric rating scale\u2009\u2265\u20094) received intranasal ketorolac. Numeric rating scale decreased in all: 32% complete pain relief, median (interquartile range) decrease \u22125 (\u22126.8 to \u22124) ( p\u2009&lt;\u2009.001). Pain relief onset was median [interquartile range] 5 (2.3, 15.0)\u2009min. Vital signs remained normal. There were no nasal mucosal changes, no complications. Minor side effects, mostly nasal burning, in 43%, resolved within 5\u2009min. Patients and nurses were satisfied with intranasal ketorolac, and would use it again. Intranasal ketorolac had a rapid onset, was effective, safe, well tolerated with minor side effects that resolved quickly.<\/jats:p>","DOI":"10.1177\/01939459211030336","type":"journal-article","created":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T05:34:55Z","timestamp":1628314495000},"page":"1047-1056","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Intranasal Ketorolac for Acute Pain in Adult Emergency Department Patients"],"prefix":"10.1177","volume":"44","author":[{"given":"Elizabeth","family":"Gaul","sequence":"first","affiliation":[{"name":"Emergency Services Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy","family":"Barbour","sequence":"additional","affiliation":[{"name":"Emergency Services Institute, Cleveland Clinic, Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy S.","family":"Nowacki","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA"},{"name":"Department of Medicine, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2011-8407","authenticated-orcid":false,"given":"Sharon E.","family":"Mace","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, MetroHealth Medical Center\/Cleveland Clinic Emergency Medicine Residency, Emergency Services Institute, Cleveland, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,8,7]]},"reference":[{"key":"bibr1-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2019.158489"},{"key":"bibr2-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2017.10.016"},{"key":"bibr3-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2015.08.003"},{"key":"bibr4-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2009.00647.x"},{"key":"bibr5-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2019.06.001"},{"key":"bibr6-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2018.04.007"},{"key":"bibr7-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(01)00349-9"},{"key":"bibr8-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1093\/bjaceaccp\/mku044"},{"key":"bibr9-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2009.10.023"},{"key":"bibr10-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2011.05.065"},{"key":"bibr11-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2020.06.049"},{"key":"bibr12-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2012.744302"},{"key":"bibr13-01939459211030336","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2018.12.025"},{"key":"bibr14-01939459211030336","doi-asserted-by":"crossref","unstructured":"Kelly A. 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