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Pain Management in the Emergency Department

July 2006


There is much in poetry and prose to commend pain. Athletes remember it as the gateway to prowess. Lovers cling to it as a hope or a memory. And musicians use it as their inspiration. This is all well and good, but is not reflective of life in the emergency department (ED). In the ED, pain is almost ubiquitous. It presents acutely or chronically and accompanies almost every disease. It strikes anyone from infancy to elderly. While the poets may embrace it and wax eloquently, real people flee from it… to the ED.

While the ED may be the haven for those in pain, effective pain management strategies are often not implemented as part of the ED visit. Indeed, emergency physicians, as well as most other specialists, do not have an admirable record when it comes to managing pain – it is frequently an after thought, overlooked, or encumbered by fears of creating addiction or supporting drug seeking behaviors. 1-3 The truth is, the vast majority of ED patients are not “drug-seekers,” but seekers of pain relief. Failing to properly address and control pain can detract from a successful resuscitation, stabilization, or diagnostic intervention. Though not necessarily predictable of patient satisfaction, it can definitely promote satisfaction with the overall ED experience.4, 5

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