Acil Serviste Akut Ağrılı Durumların Tedavisi

The management of patients presenting to the emergency department with acute pain is a critical process that must be conducted simultaneously with diagnostic evaluations, aiming to alleviate pain in the shortest time possible with minimal side effects. The International Association for the Study of Pain (IASP) defines pain as an unpleasant sensory and emotional experience accompanying tissue damage. To block the mechanisms involved in pain physiology, opioids and paracetamol act by reducing pain perception in the central nervous system, while nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit inflammation and local anesthetics interrupt nerve conduction. Pain severity should be determined using assessment scales appropriate for age and state of consciousness, such as NRS, VAS, FLACC, and BPS, based primarily on the patient's self-report, and re-evaluations should be performed at 15-30 minute intervals. Specific pharmacological treatments are applied in the emergency department for clinical conditions such as migraine, tension-type headache, soft tissue injury, renal colic, acute abdominal pain, burns, and fractures/dislocations. It is established that the use of opioids and paracetamol in conditions like abdominal pain does not mask physical examination findings or cause diagnostic delays. In addition to pharmacological treatment, non-pharmacological methods—such as psychological interventions including patient education, breathing, and distraction exercises, as well as TENS, acupuncture, hot/cold applications, immobilization, and proper positioning—contribute to pain palliation either alone or in combination. In conclusion, since acute painful conditions are frequently undertreated in the emergency department, appropriate analgesic agents at correct doses should be initiated at the earliest stage in all non-contraindicated patients.