Pain management framework in the emergency department: patterns in 40 emergency departments worldwide

Many studies illustrate variation in pain management protocols in emergency medicine. This study examines analgesia frameworks in emergency departments (EDs) in multiple countries, compares them with the recent literature, and illuminates the variability in protocols and treatment. A survey was conducted assessing the pain management framework and practices in a convenience sample of 40 hospitals distributed over 22 countries. Most EDs (80%) indicated that pain intensity was routinely documented, most commonly (42.5%) using a verbal numerical 0-10 scale. Most (57.5%) reported specific protocols for specific conditions, with 56.5% reporting that these protocols were mandatory. Structured training was reported by 27.5% of responders. All (100%) reported analgesia administration in the trauma room. Oral paracetamol (67.5%) and intravenous morphine (92.5%) were the most commonly used analgesics. The variability in the pain management framework is high among EDs worldwide, highlighting the need for more international uniformity in analgesia practices in the ED.