Quick Chart
  • Pain is an unpleasant sensation, an emotional response to that sensation and is associated with actual or potential tissue damage.
  • Pain is always subjective and multifactorial involving both physical and psychological processes.
  • The objective of effective relief of pain is to reduce the pain perceived by the patient to a tolerable level without causing serious side effects.
  • A drop in ≥2 points on the pain scale in patients experiencing severe pain is clinically significant.
  • Initial and subsequent pain scores must be recorded to determine analgesia effectiveness.
 Clinical Presentation
  • Perform OPQRST assessment:
    • Onset
    • Provocation or palliation
    • Quality of pain
    • Region and radiation
    • Severity
    • Time
  • Choice of pain relief is dependent on the aetiology of the pain and the pharmacology of the medication.
  • PAINLOGTM is a visual analogue for assessing changes in pain level. Ask the patient to slide the pointer to match their pain level and record the score.  Reassess as required.
 Exclusion Criteria
Exclusion Criteria
 Risk Assessment
  • Bradypnoea & hypoventilation is a common side effect of analgesics.
  • All patients receiving pain medication must be monitored with a pulse oximeter.
  • Patients under extended care (e.g. 'ramped' patients) have usually received analgesia prior. Loading doses are not indicated in this setting.
  • Evidence suggests that concurrent use of multiple pain-relieving strategies, including pharmacological and non-pharmacological interventions, provides superior pain relief when compared to any single approach to pain management alone.
Primary Care
Non-Pharmacological Interventions:
  • Communication:
    • Empathy
      • Acknowledge and validate the patients pain
      • Alleviate their concerns and explain processes of pre-hospital care.
    • Reassurance
      • Establishes confidence in the care-giver and setting the expectation of analgesic effectiveness reduces patient suffering.
      • Reassurance reduces psychophysiological reactions.
    • Distraction
      • Distract patients with conversation
      • Particularly effective and necessary for paediatric patients.
      • Provide alternative focus for patient to concentrate on.
      • Useful in protracted extrications.
  • Other:
    • Patient Positioning
    • Immobilisation & Splinting
    • Cooling / Icing
Intermediate Care

Pharmacological Intervention:

Note: Medications form just one component of an effective analgesia regime and should, in conjunction with non-pharmacological approaches as well as each other, be used in a multimodal approach encompassing both opioid and non-opioid analgesics.

Advanced Care
Pharmacological Intervention:

Note: Medications form just one component of an effective analgesia regime and should, in conjunction with non-pharmacological approaches as well as each other, be used in a multimodal approach encompassing both opioid and non-opioid analgesics.

Critical & Extended Care
Pharmacological Intervention:
 Additional Information
  • Record pain score before and after treatment to assess effectiveness.
  • Regular vital signs recordings are necessary to confirm effectiveness as well as checking for possible adverse effects.
  • Beware of the synergistic effects of combining pain relieving medications.
  • Allow sufficient time for medication to take effect and follow the time intervals as described in the individual medication guidelines.
Key Terms & Links
Analgesia Infographic
Click to expand


Extended Care:
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