Pain management in the prehospital environment

Pain is the leading complaint among individuals presenting to emergency departments, with up to 70% of emergency department patients having pain as part of their chief complaint [1]. Therefore, pain is also a major reason why individuals seek care from prehospital providers. In fact, McLean et al [2] found that at least 20% of prehospital patients reported moderate or severe pain. Multiple other studies [3-7] have also demonstrated that prehospital providers and emergency physicians fail to adequately recognize, assess, and treat pain. These inadequacies in prehospital pain management have resulted in recommendations to incorporate assessment scales and treatment protocols, and to undertake further pain research [6-9]. Despite these recommendations, many emergency medical services (EMS) systems still lack protocols that adequately address and treat pain in the prehospital setting.