Introductory paragraph: We would like to thank the authors of their letter to the editor “Awareness Strategies and the Physiological Impact of Pain in Prehospital Analgesia Management” for their thoughtful and insightful comments on our study. We appreciate their recognition of the significance of our findings and their emphasis on improving pain management in prehospital care. The challenges they highlight align with the broader discussions on pain assessment and analgesia management, and we acknowledge the importance of the four key issues outlined by the Royal College of Emergency Medicine.