Patient report of pain is the gold standard
Build trust by believing the patient is in pain
Sickle cell pain is usually severe and requires immediate treatment; evidence-based guidelines recommend administering pain medication within 60 minutes of arrival
Vital Signs/Neuro Status
Past Medical History
Initiation of Care Should Not Be Delayed Due to Space Constraints
History – Part 1
History – Part 2 (after Evaluation and initial orders placed)
Physical Exam/Differential Diagnosis
Adjuncts for Pain
Manage Opioid Side Effects
Patient-Controlled Analgesia (PCA)
Treatments to Use with Caution or Avoid
Caroline Freiermuth, MD, MS, FACEP (co-Chair) Patricia Kavanagh, MD (co-Chair) Vicki Basalyga, PharmD, BCPS, BCPPS, ASHP Amanda Brandow, DO David Brousseau, MD, MS Aubri Carman, MD Patrick Carroll, MD Corrie Chumpitazi, MD, MS, FAAP, FACEP Emelia Frederick, MSN, RN, CEN Jon Mark Hirshon, MD, PhD, FACEP E. Donnell Ivy, MD Sophie Lanzkron, MD, MHS Logan Ramsey, MD JJ Strouse, MD, PhD Henry Young II, MD, FACEP
Loren Rives, MNA Riane Gay, MPA Mandie Mims, MLS Eileen Aguilar, MS Marla Payne
The American College of Emergency Physicians (ACEP) makes every effort to ensure that contributors and editors of its resources are knowledgeable subject matter experts and that they used their best efforts to ensure accuracy of the content. However, it is the responsibility of each user to personally evaluate the content and judge its suitability for use in his or her medical practice in the care of a particular patient. Users are advised that the statements and opinions expressed in this resource are provided as recommendations of the contributors and editors at the time of publication and should not be construed as official College policy. ACEP acknowledges that, as new medical knowledge emerges, best practice recommendations can change faster than published content can be updated. ACEP recognizes the complexity of emergency medicine and makes no representation that this resource serves as an authoritative resource for the prevention, diagnosis, treatment, or intervention for any medical condition, nor should it be used as the basis for the definition of or the standard of care that should be practiced by all health care providers at any particular time or place. To the fullest extent permitted by law, and without limitation, ACEP expressly disclaims all liability for errors or omissions contained within this resource, and for damages of any kind or nature, arising out of use, reference to, reliance on, or performance of such information.
Copyright 2021, American College of Emergency Physicians, Dallas, Texas. All rights reserved. Produced in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this resource may be reproduced or distributed in any form or by any means or stored in a database or retrieval system without prior written permission of the publisher.
Requests for permission should be sent here.