Pain Management in Acute and Emergency Settings

Source: Pain Management presentation by Daniel Stone, MD

Pain Management in Acute Care: Balancing Relief, Safety, and Clinical Judgment

Pain is one of the most common reasons patients seek emergency care, yet it remains one of the most complex symptoms to manage safely and effectively. This session explores evidence-based pain management strategies with a focus on acute care environments and resource-variable settings.

Pain Is Subjective, But Risk Is Not

While pain is inherently subjective, the risks associated with pain treatment are very real. This presentation emphasizes careful assessment, reassessment, and matching analgesic choice to clinical context rather than pain score alone.

Acute vs Chronic Pain

The physiological mechanisms behind acute and chronic pain differ significantly. Acute pain is often nociceptive and inflammatory, while chronic pain involves central sensitization and neuroplastic changes. Because of this, treatment strategies must differ.

The session reviews:

First-line agents for acute pain

Why chronic pain should not be managed with short-term emergency strategies

Common mistakes that lead to over- or undertreatment

Multimodal Analgesia

Effective pain control rarely relies on a single medication. Combining acetaminophen, NSAIDs, opioids when appropriate, and adjunctive agents allows clinicians to reduce opioid exposure while maintaining adequate analgesia.

Special attention is given to:

Appropriate opioid use for severe acute pain

Risks of misuse, dependence, and respiratory depression

Non-opioid adjuncts and their limitations

Analgesia vs Sedation

A critical distinction in emergency medicine is the difference between analgesia and sedation. This session clarifies provider intent, monitoring requirements, and how dissociative or amnestic agents fit into procedural care.

Slides: (Link to PowerPoint here)