Pain Management During and After
Your Emergency Department (ER) Visit
This handout was written to help you
understand pain management. It describes
ξ How pain is managed in the ER.
ξ How to work with your doctors and
nurses to get the best pain control.
ξ Types of pain treatment.
ξ A pain control plan for after you leave
Pain is a common reason many people come
to the ER. There are many causes of pain.
Illness, injury, infection, and even some
types of treatment can all cause pain. People
feel pain in different ways. Many things can
affect how you feel pain and to what degree
a person feels pain. Sometimes, pain is just a
small nuisance. At other times pain can
affect you in many ways. It can keep you
from sleeping, eating, and being active. Pain
can also make you feel afraid or depressed.
Pain management is a key part of your care
in the ER. Finding the cause of your pain
and controlling your pain can improve the
results of your care.
How pain is managed in the ER
The main goal of your care in the ER is to
find out what’s wrong with you and to
provide emergency care. Although we want
you to be as comfortable as you can be
during your visit, a doctor will need to see
you before we can give you any pain
medicine. The doctors and nurses will work
with you to find the best and safest way to
control your pain during your visit. Please
let us know if there are pain treatments that
have been helpful to you in the past. We
will work to provide timely pain
management during your visit.
The person with pain is the only one who
really knows the pain is present and how bad
it is. There are no tests or scans to measure
how much pain a person is having. Pain can
be a sign of a problem. The nurse and
doctor want and need to know about it, what
it feels like, and how it impacts you. Many
things can affect your pain control.
We may use methods other than giving you
medicine to help treat your pain.
ξ Cold pack
ξ Heat pack
If you have chronic pain
Chronic pain takes a toll on your body,
mind, and soul. Often, you may feel like
you have little control over what’s going on
with your body. There is no magic pill or
cure to relieve chronic pain. We want to
relieve pain and suffering, yet do no harm.
Pain relief from narcotic (opioid) shots lasts
only a short time. After this time, you may
notice your pain not only increases, but also
it may return more often. Using short-term
or “rescue” narcotics can increase stress and
Often, the ER is not the best place to
manage pain, especially chronic pain flares.
Patients tell us that long waits in the ER are
common. The noise and chaos often
worsens pain. The best results for managing
your chronic pain will be achieved by
working with your primary care doctor.
This involves learning more about how to
prevent the pain as well as what treatments
are best for you to use at home. Your ER
team can check you to make sure there is no
new problem. But you and your primary
doctor may need to work with a pain
specialist to set up a plan that is best for
How to get the best pain control
It is crucial that you take an active role in a
plan to control your pain. Be sure to talk to
your doctors and nurses about these things.
1. Ask the doctor or nurse what to
ξ Will there be much pain with your
injury, illness or treatment?
ξ What are the options you can use for
your type of pain during your ER
2. Discuss your pain control options with
your doctors and nurses.
ξ Talk with your nurses and doctors
about pain control methods that have
worked well or not so well for you
ξ Talk with your nurses and doctors
about any concerns or fears you may
have about pain medicine.
ξ Tell your doctors and nurses about
any allergies to medicines you may
ξ Ask about side effects that may occur
with pain treatment.
ξ Talk with your doctors and nurses
about the medicines you take for
other health problems. We need to
know, adding over the counter or
herbal medicines can cause
3. Help the doctors and nurses
“measure” your pain.
ξ Use a pain scale to describe your
pain. For pain management to work,
you need to have some way to help
your doctors and nurses be aware of
how much you are hurting. You may
be asked to use a “pain rating scale”
to do this. On a scale of 0 to 10,
with 0 being no pain, and 10 being
the worst pain you can think of, how
much pain do you have right now?
ξ Tell your doctors and nurses where
your pain is, what it feels like, if it
changes, and if you feel the pain all
the time or only at certain times.
4. Work with you doctors and nurses to
make a pain control plan.
ξ Talk to your doctors and nurses
about how they will treat your pain
in the ER. Ask about a realistic pain
control goal during your visit (for
instance, reducing your pain enough
to get through a test such as a CT
ξ You may or may not need
prescription or over-the-counter pain
medicine. You need to understand
the different kinds of pain medicines
and how to use them safely for your
type of pain.
ξ Make sure you understand the plan
for pain control after you leave the
ER and who to call if you have any
questions or problems.
This information is given to help you discuss
your options with your doctors and nurses.
Sometimes, it is best to combine two or
more of these treatments or change the
treatments slightly to meet your needs.
There are many medicines that can be used
to treat pain. They can be divided into three
1. Aspirin, nonsteroidal anti-inflammatory
drugs (NSAIDS), and acetaminophen
2. Opioids (narcotics)
3. Adjuvant medicines including local
Nonsteroidal anti-inflammatory drugs
(NSAIDs) and acetaminophen (Tylenol )
This includes aspirin and other “aspirin-like”
medicines such as ibuprofen (Motrin ,
Advil ) and naprosyn (Aleve ) as well as
acetaminophen (Tylenol ). These drugs are
given for mild to moderate pain or as an
added medicine with opioids for severe pain.
The main way these medicines work is to
decrease the sensitivity of the nerves to pain
and reduce inflammation. There is a limit to
how much you can take of each of these
medicines. Except for acetaminophen
(Tylenol ), they interfere with blood
clotting, and can also cause nausea, stomach
bleeding, or kidney problems. For more
information ask for Health Facts for You
These include morphine, hydromorphone,
codeine, oxycodone, fentanyl, and others.
These drugs are given for moderate and
severe pain. They require a prescription.
They work mainly by blocking pain
sensation in the spinal cord and brain. These
medicines can be given in a variety of ways
including by the mouth (pills), through the
rectum (suppositories), through a vein
(intravenous), near the spinal cord (spinals
or epidurals), or through the skin
(transdermal patches). Side effects may
include drowsiness, nausea, constipation,
and slowed breathing. For more information
about opioids, ask for Health Facts for You
There are many other types of medicines that
have pain-relieving qualities. Many of these
medicines (certain antidepressants,
anticonvulsants, and steroids) are very
helpful when treating certain types of pain.
Local anesthetics are numbing medicines
that can sometimes be placed on the skin or
injected under the skin to provide short-term
Non-drug methods to relieve pain
There are many other ways to reduce pain.
These methods can be effective for all types
of pain and can boost the pain-relief effects
ξ Cold or warm packs
ξ Distraction can be as simple as watching
TV or reading a book, or as complex as a
recording that instructs you on activities
ξ Imagery is using your imagination to
create mental pictures or situations to
help reduce your pain
Just as with medicine, all the methods listed
above may not work for you. You will want
to try a few methods, both alone and
together to see which work best for you.
A pain control plan after you leave
You will be given a set of written
instructions for your care after you leave the
ER. If you need continued pain
management after you leave, the instructions
will include information about a pain
management plan. A pain management plan
is a way to organize all the possible ways to
reduce your pain. A pain management plan
may include a list of medicines and other
non-drug treatments you can use to manage
your pain. If pain medicine is needed we are
only able to provide a limited supply to
manage the acute need until you can see
your regular doctor. It is important to
understand which doctor or clinic to contact
for follow-up care or questions after you
leave the ER.
Your input into the plan is vital if it is to
work. Be sure the plan makes sense to you.
You must be able to both understand and
follow it. There is no one best plan that
works for all people. What works today may
not be the best plan in a week or a month
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©9/2017. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6754.