Box plot showing the median TTFA and 25th to 75th IQR for ESI groups 2 and 3 with NHLBI first analgesic recommendation cutoff highlighted in red. Median TTFA was 65 minutes for ESI 2, and 178 minutes for ESI 3 (P < .001). IQR for TTFA in patients assigned an ESI of 2 was 56 to 103 minutes, whereas the IQR for patients assigned an ESI of 3 was 98 to 445 minutes. The 30-minute cutoff for TTFA from triage as recommended by NHLBI is highlighted in red. None of the patients had TTFA within the recommended cutoff.