Assessment is important: Is this new pain because the patient is constipated? Gastritis? Injured?
Antidepressant and Anti-epileptics have role (has the patient recently stopped them?)
Is the patient still taking their Paracetamol + NSAID (i.e. baseline).
Better for the patient to be given Breakthrough pain relief and to see Pain Team in elective setting for objectivity.
When to reach for Strong Opiates (Morphine preparations)
In Acute Visceral Pain
ONLY once all of the above options have been utilised
Titrate to response
Managing Injuries in the ED
Decide how you are going to TREAT the pain!
Reduce, Splint, Cover or Irrigate?
Paracetamol + NSAID +- Simple opioid (codeine NOT Morphine).
Procedural Analgesia and Sedation
- See separate Sedation Policies for Adults and Children
- Short acting opiates such as Fentanyl for the procedure itself ±
- Short acting Hypnotic (e.g. See policy) or