Optimizing the Treatment of Acute Pain in the ED-Optimizing the Treatment of Acute Pain in the ED

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The document is a policy statement from the American College of Emergency Physicians (ACEP) regarding optimizing the treatment of acute pain in the emergency department (ED). The policy statement provides guidelines for pain management in the ED, focusing on pharmacological and non-pharmacological treatments.<br /><br />For pharmacological treatments, the document recommends starting with non-opioid agents when possible. Non-steroidal anti-inflammatory drugs (NSAIDs) are suggested as a first-line option but should be used with caution in patients with certain conditions. Acetaminophen is another option for mild to moderate pain. Regional anesthesia, sub-dissociative dose ketamine, intravenous lidocaine, and topical lidocaine patches are also mentioned as potential treatments for specific painful conditions. The use of opioid analgesics is common in managing acute severe pain but should be carefully considered due to the risks involved.<br /><br />Non-pharmacological treatments are also highlighted as an important aspect of pain management. These include patient-centered communication techniques, physical interventions, ice/heat, topical coolant sprays, recommendations for activity and exercise, and relaxation techniques. Mind-body therapies are mentioned as having documented efficacy but their effectiveness for ED patients is unclear.<br /><br />The policy statement also provides definitions for terms such as tolerance, physical dependence, addiction, and opioid-induced hyperalgesia. It emphasizes the need for individualized treatment plans, coordination with primary pain management providers, and the use of prescription-monitoring programs to identify patients at risk for opioid abuse.<br /><br />Overall, the document emphasizes the importance of prompt, safe, and effective pain management in the ED, using multimodal approaches that incorporate both pharmacological and non-pharmacological interventions. It provides specific recommendations for various treatment options while highlighting the potential risks and considerations associated with opioids.

Meta Tag

acute pain chronic pain

acute pain opioid

acute pain exam

acute pain screening

acute pain prescription

acute pain medication

acute pain addiction

Keywords

acute pain

emergency department

pain management

pharmacological treatments

non-pharmacological treatments

NSAIDs

acetaminophen

opioid analgesics

mind-body therapies

individualized treatment plans