Guidelines for the management of acute pain in emergency situations - 2025 update

Sep 23, 2026

Uploaded by Mimi

Guidelines for acute pain management in emergency and pre-hospital settings synthesize current evidence and best practice to support safer, more effective, and equitable pain control. Emphasis is placed on systematic, repeated pain assessment from first contact through discharge using validated tools, acknowledging pain’s subjective nature. Recommendations adopt a multimodal, mechanism-based approach, prioritizing foundation-of-care assessments, non-opioid options where feasible, and stewardship to address opioid misuse and related adverse events.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages138

Reading Time5 h 48 min

AccessFree to download

Contents

Chapter 1: The current state of acute pain management in emergency situations in Europe

Chapter 2: Principles of acute pain management

Chapter 3: Assessment of pain

Chapter 4: Non-pharmacological therapies in acute pain

Chapter 5: Pharmacological therapies in acute pain

Chapter 5 supplement: Overview of clinical data for pharmacological treatment options for acute pain management

Chapter 6: Practical considerations for the assessment of pain in pre-hospital and emergency hospital settings

Chapter 7: Management of pain in pre-hospital and emergency hospital settings - considerations

Chapter 8: Recommendations for acute pain management in emergency settings

Guidelines for the management of acute pain in emergency situations 2025 Update October 2025 Published by: The European Society for Emergency Medicine (EUSEM) Antwerpsesteenweg 124 B27 B – 2630 Aartselaar Belgium [Website: www.eusem.org](Website: www.eusem.org) ©European Society of Emergency Medicine 2025 Guidelines for the management of acute pain in emergency situations – 2025 update EUSEM Guideline Authors Professor Saïd Hachimi-Idrissi, Full Professor of Emergency Medicine at the University of Ghent, Belgium; Professor of Pediatric and Critical Medicine at the Vrije Universiteit Brussel, Brussels, Belgium; Critical Care Department and Cerebral Resuscitation Research Group, Universiteit Ziekenhuis Ghent, Belgium. Professor Frank Coffey, Emergency Medine Physician, Director DREEAM, Nottingham University Hospitals NHS Trust UK; Honorary Professor Urgent and Emergency Care, Nottingham Trent University UK. Assistant Professor Viliam Dobias, Head Medical Supervisor at Life Star Emergency Prehospital EMS Llc. , Limbach, Slovakia. Professor Wolf Hautz, Consultant Physician, Director of Research; Senior Lecturer, Department of Emergency Medicine; Inselspital University Hospital Bern, Switzerland. Dr Robert Leach, Head of the Department of Emergency Medicine, Centre Hospitalier de Wallonie Picarde, Tournai, Belgium; President of EUSEM. Dr Carlos Lojo Rial, Consultant Emergency Medicine, Emergency Department, Kingston Hospital NHS Trust, UK. Professor Thomas Sauter, Head of Education and Clinical Simulation Program, Consultant Emergency Medicine, University Emergency Center, Inselspital, Universitätsspital Bern, Switzerland. Dr Idanna Sforzi, Consultant Physician Emergency, Emergency Department and Trauma Center, Meyer Children’s Hospital IRCCS, Florence, Italy. Author contributions All authors had access to all data and evidential materials and take responsibility for the integrity of the guideline and the accuracy of analyses. All authors were involved in the concept and design of the guidelines, drafting the guideline handbook and critical revision of all drafts. Acknowledgments The authors would like to acknowledge the efforts of Brandfish Limited, particularly Susan Allen, Julie Jenkins and Jen Turner for their assistance in data and project management and editorial and technical assistance. iii Guidelines for the management of acute pain in emergency situations – 2025 update Contents Chapter 1: The current state of acute pain management in emergency situations in Europe 1 Chapter 2: Principles of acute pain management 12 Chapter 3: Assessment of pain 16 Chapter 4: Non-pharmacological therapies in acute pain 23 Chapter 5: Pharmacological therapies in acute pain 30 Chapter 5 supplement: Overview of clinical data for pharmacological treatment options for acute pain management 47 Chapter 6: Practical considerations for the assessment of pain in pre-hospital and emergency hospital settings 81 Chapter 7: Management of pain in pre-hospital and emergency hospital settings – considerations 88 Chapter 8: Recommendations for acute pain management in emergency settings 112 iv Guidelines for the management of acute pain in emergency situations – 2025 update Foreword: EUSEM President The management of acute pain in emergency and pre-hospital settings stands at a pivotal crossroads. Over the past five years, the landscape has evolved rapidly, propelled by the opioid crisis, advances in pharmacological and nonpharmacological therapies, and the increasing integration of technology in clinical practice. The imperative for safer, more effective, and equitable pain control has never been clearer—or more pressing. Pain remains the leading reason for emergency medical attendance across Europe and globally. Yet, despite its prevalence and the well-documented harm of both under-and over-treatment, practice remains inconsistent. Historical reliance on opioids for moderate-

FAQs

What is the key starting point for effective acute pain management in these guidelines?

The guidelines prioritize systematic, repeated pain assessment from first contact through to discharge using validated tools.

How do the guidelines address the opioid crisis and opioid misuse?

They highlight the harm of under- and over-treatment and stress opioid stewardship, advocating non-opioid agents where feasible and safer, evidence-based choices.

What approach do the guidelines recommend for pain relief?

A multimodal, mechanism-based approach is recommended, integrating advances in both pharmacological and non-pharmacological therapies tailored to patient needs, including vulnerable groups.

Sep 23, 2026

Uploaded by Mimi