Authors: Tom Bannister / Codes: CP1, EP5, GP1, GP8, MaP1, MuC4, MuC5, MuP1, MuP2, MuP3, ObP1, OptP3, PalC4, PC1, PC2, PC3, SLO1, SLO3, SLO4, SuP1, SuP6, UP4, UP5 / Published: 01/05/2024
Scope / Reason for development
This guideline sets out the standards for timeliness of provision of analgesia and provides an approach to the delivery of analgesia for adult patients presenting to the emergency department (ED). Pain management is one of the most important components in patient care.
Summary of Recommendations
- Recognition and alleviation of pain should be a priority when treating the ill and injured. This process should start at triage, be monitored during their time in the ED and continue through to admission or discharge ensuring adequate analgesia is provided at all times, including beyond discharge where appropriate.
- All emergency departments should ensure patients with moderate and severe pain receive adequate analgesia within 15 minutes of arrival.
- All emergency departments should ensure patients in severe pain have the effectiveness of their analgesia re-evaluated within 15 minutes of receiving the first dose of analgesia.
- All emergency departments should ensure the routine recording of pain in a similar manner as the regular documentation of vital signs.
- All emergency departments should audit pain management at least annually. Audit should consider equity of analgesia provision across protected characteristics.
- Emergency department patient surveys should include specific questions regarding pain management.
- Training in pain relief for all staff involved in patient care is essential to ensure timely and effective management.
Ensure that you read the full Suspected Nitrous Oxide Toxicity in the ED Guideline
Key Information
Avoid NSAIDS in asthmatics who are known to get worsening bronchospasm with NSAIDS, also avoid in patients with previous or known peptic ulcer disease. NSAIDs should be used with caution in the elderly (risk of peptic ulcer disease) and women who are experiencing fertility issues. They should also be avoided in pregnancy, particularly during the third trimester.
Linked RCEMLearning Content
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