Tim, the Rogue Medic is working hard on changing the way we approach pain management in ALS care. For far too long we as paramedics and medics have been timid about the way we medicate our patients when they are in pain.

To be fair, most of our hands are tied by Medical Directors who believe that we will cater to drug seekers and increase addiction in our communities with the opiods most of us carry. Once we get to the hospital, these patients get immediately get morphine, fentanyl, dilauded, or other strong pain meds and then are left alone in the ER room as the nurses go about their business.

Aggressive Pain Management is Good Patient Care

Anyone who’s worked in the ED or any other part of the hospital knows the docs give out pain meds like they are candy. This isn’t a bad practice. Pain should be managed without the prescriber’s prejudices getting in the way.

So why are we negligently ignoring the prehospital patient’s pleas about their pain while in the field?

Do they think we can’t spot respiratory depression sitting just a few feet away from the patient the whole time?

In the ER, that patient is going to get strong pain meds and then will be left alone for 15, 20, 30 minutes or longer.

Pain management protocols for EMS providers need to be loosened up to allow us to give our patients the same level of pain relief that they will get in the hospital.

Rogue Medic Leads the Charge

I’m looking forward to the Rogue Medic’s articles and research on this topic in the days and weeks to come. Tim is compiling a very complete collection of the existing research on prehospital pain management. I hope that this will garner the attention needed to move forward the pain management protocols to something that is more effective than what is currently available in most systems.


How do you look at pain management? Leave a comment and let us know.


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One Response to Rogue Medic Compiles EMS Pain Management Resources

  1. Rogue Medic says:

    Thank you for the kind words and for bringing attention to this.

    As with violence against EMS providers, undertreatment of pain is often ignored. When pain is not taken seriously, what other medical conditions are not taken seriously?

    Opioids are some of the safest drugs we have, so the focus on preferentially restricting opioids demonstrates a lack of understanding on the part of those writing protocols that discourage appropriate and aggressive pain management.

    With assaults on EMS, with aggressive sedation of patients, there is both protection of the patient (as with pain management), but there is also protection of EMS from further violence from the sedated patient.

    As with protocols that discourage pain management, protocols that discourage appropriate and aggressive sedation demoinstrate a lack of understanding on the part of those writing the protocols.

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