90 patients presenting to the emergency department with moderate to severe pain due to mild or moderate blunt trauma were randomized to be managed with either intranasal (IN) ketamine, intravenous (IV) morphine, or intramuscular (IM) morphine. Patients were assessed for pain every 5 minutes for the first 60 minutes after administration. Results demonstrated significantly earlier onset of clinically relevant pain reduction in the IN ketamine and IV morphine groups compared to the IM morphine group. Adverse events related to confusion, dizziness, and difficulty concentrating were more frequent following IN ketamine administration, while morphine administration was associated with a greater incidence of dry mouth.