Pain Management in the Emergency Department- Newer Modalities and Current Perspective

Abstract

Pain is one of the most common complaints and yet one of the most neglected aspects of management in the emergency department. Optimal pain management is a nuanced skill which focusses on reduction of pain to an acceptable level to allow for safe discharge and return to normal activities, in addition to improving patient satisfaction and comfort during their stay in hospital. Adequate analgesia also improves physiological parameters such as heart rate and blood pressure. The aim is improving rather than eradication of pain altogether while maintaining an acceptable level of adverse effects. This chapter will discuss assessment of pain in the emergency department along with various modalities of pain management with specific focus on newer modalities including ultrasound guided regional nerve blocks. Ultrasound guided nerve blocks are associated with better analgesia and have fewer chances of drug related adverse events, especially in older patients and those with comorbidities where large doses of systemic medications are associated with a significant risk of adverse effects.