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J Emerg Med. 2018 May;54(5):731-736. doi: 10.1016/j.jemermed.2018.01.020. Epub 2018 Mar 6.

The Treatment of Acute Pain in the Emergency Department: A White Paper Position Statement Prepared for the American Academy of Emergency Medicine.

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Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York.
Department of Emergency Medicine and Toxicology, Massachusetts General Hospital, Boston, Massachusetts; Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts.
Department of Emergency Medicine, University of Tennessee-Murfreesboro, Murfreesboro, Tennessee.
Department of Emergency Medicine, Mountainside Medical Center, Montclair, New Jersey.
Department of Emergency Medicine, Trumbull Memorial Hospital, Warren, Ohio.
Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Department of Emergency Medicine and Intensive Care Unit, Northern Health, Melbourne, Australia.
Department of Emergency Medicine and Medical College, Albert Einstein College of Medicine, Bronx, New York.
Department of Emergency Medicine, University of California, San Diego School of Medicine, San Diego, California.



Pain is one of the most common reasons patients present to the emergency department (ED). Emergency physicians should be aware of the numerous opioid and nonopioid alternatives available for the treatment of pain.


To provide expert consensus guidelines for the safe and effective treatment of acute pain in the ED.


Multiple independent literature searches using PubMed were performed regarding treatment of acute pain. A multidisciplinary panel of experts in Pharmacology and Emergency Medicine reviewed and discussed the literature to develop consensus guidelines.


The guidelines provide resources for the safe use of opioids in the ED as well as pharmacological and nonpharmacological alternatives to opioid analgesia. Care should be tailored to the patient based on their specific acute painful condition and underlying risk factors and comorbidities.


Analgesia in the ED should be provided in the most safe and judicious manner, with the goals of relieving acute pain while decreasing the risk of complications and opioid dependence.


analgesia; emergency; emergency care; opioids; pain; pain control

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