Approaching acute pain in emergency settings; European Society for Emergency Medicine (EUSEM) guidelines—part 2: management and recommendations

Saïd Hachimi-Idrissi, Robert Leach

Onderzoeksoutput: Articlepeer review

16 Citaten (Scopus)

Samenvatting

BACKGROUND: In Europe, healthcare systems and education, as well as the clinical care and health outcomes of patients, varies across countries. Likewise, the management of acute events for patients also differs, dependent on the emergency care setting, e.g. pre-hospital or emergency department. There are various barriers to adequate pain management and factors common to both settings including lack of knowledge and training, reluctance to give opioids, and concerns about drug-seeking behaviour or abuse. There is no single current standard of care for the treatment of pain in an emergency, with management based on severity of pain, injury and local protocols. Changing practices, attitudes and behaviour can be difficult, and improvements and interventions should be developed with barriers to pain management and the needs of the individual emergency setting in mind.

METHODS: With these principles at the forefront, The European Society for Emergency Medicine (EUSEM) launched a programme-the European Pain Initiative (EPI)-with the aim of providing information, advice, and guidance on acute pain management in emergency settings.

RESULTS AND CONCLUSIONS: This article provides treatment recommendations from recently developed guidelines, based on a review of the literature, current practice across Europe and the clinical expertise of the EPI advisors. The recommendations have been developed, evaluated, and refined for both adults and children (aged ≥ 1 year, ≤ 15 years), with the assumption of timely pain assessment and reassessment and the possibility to implement analgesia. To provide flexibility for use across Europe, options are provided for selection of appropriate pharmacological treatment.

Originele taal-2English
Pagina's (van-tot)1141-1155
Aantal pagina's15
TijdschriftInternal and Emergency Medicine
Volume15
Nummer van het tijdschrift7
DOI's
StatusPublished - 15 okt 2020

Bibliografische nota

Funding Information:
EUSEM acknowledges the support of this European Pain Initiative through funding by an unrestricted educational grant from Mundipharma International Limited awarded in 2018. The authors would like to acknowledge colleagues’ contribution in the early development of the European Pain Initiative including Dr Agnes Ricard-Hibon, Présidente de la Société Française de Médecine d’Urgence, Chef de Service SAMU-SMUR-SAU, GHT Nord-Ouest Vexin Val d’Oise, Pontoise 95, France and Dr Roberta Petrino, Director Emergency Department, S. Andrea Hospital, Vercelli, Italy. The authors thank Brandfish Limited, Oxfordshire, UK, for providing medical writing and editorial support, including preparing an outline of the manuscript (based on discussions with the authors and contributors), collating author comments, and developing first and final drafts of the manuscript for author review, amend and approval in accordance with Good Publication Practice (GPP3) guidelines, funded by EUSEM. All authors reviewed the manuscript at each stage, including development of reference works for inclusion and provided comments.

Funding Information:
EUSEM acknowledges the support of this European Pain Initiative through funding by an unrestricted educational grant from Mundipharma International Limited awarded in 2018. The authors would like to acknowledge colleagues’ contribution in the early development of the European Pain Initiative including Dr Agnes Ricard-Hibon, Présidente de la Société Française de Médecine d’Urgence, Chef de Service SAMU-SMUR-SAU, GHT Nord-Ouest Vexin Val d’Oise, Pontoise 95, France and Dr Roberta Petrino, Director Emergency Department, S. Andrea Hospital, Vercelli, Italy. The authors thank Brandfish Limited, Oxfordshire, UK, for providing medical writing and editorial support, including preparing an outline of the manuscript (based on discussions with the authors and contributors), collating author comments, and developing first and final drafts of the manuscript for author review, amend and approval in accordance with Good Publication Practice (GPP3) guidelines, funded by EUSEM. All authors reviewed the manuscript at each stage, including development of reference works for inclusion and provided comments.

Funding Information:
Outside of the submitted work, SHI received speaker honorarium from Mundipharma Research UK in 2017; FC has been an advisory board member and received speaker honorarium fees from Mundipharma International Limited; VD has received speaker honorarium fees and been an advisory board member for Mundipharma International Limited; WH has received research funding from Mundipharma Research UK, and conference attendance fees from Mundipharma Medical Basel, EBSCO Berlin, ISABEL Healthcare and speaker honorarium from AO Foundation Zurich; RL has no competing/conflicts of interests to disclose; TS has received research grants or lecture fees from Bayer, Boehringer Ingelheim, Daiichi-Sankyo and the Gottfried and Julia Bangerter-Rhyner Foundation; IS has no competing/conflicts of interests to disclose.

Publisher Copyright:
© 2020, Società Italiana di Medicina Interna (SIMI).

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

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