Emergency department pain management in special populations

Katherine Vlasica; Amanda Hall; Mohammad Anzal Rehman; George Notas; Christina Shenvi; Sergey Motov

doi:10.4103/tjem.tjem_141_25

Katherine Vlasica¹, Amanda Hall¹, Mohammad Anzal Rehman², George Notas³, Christina Shenvi⁴, Sergey Motov⁵

¹Department of Emergency Medicine, St. Joseph’s Health, Paterson, NJ, USA
²Department of Emergency Medicine, Mediclinic City Hospital, Dubai, UAE
³Department of Emergency Medicine, University Hospital of Heraklion, Crete, Greece
⁴Department of Emergency Medicine, University North Carolina Hospitals, Chapel Hill, NC, USA
⁵Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, NY, USA

Keywords: Analgesia, emergency department, pain management

Abstract

Pain is a leading cause of emergency department (ED) visits globally, yet certain patient populations experience persistent disparities in their pain management due to physiological complexities, comorbidities, and gaps in evidence based guidelines. This clinical review focuses on individualized, evidence based approaches to ED pain management in four vulnerable groups: pregnant and breastfeeding patients, patients with sickle cell disease, geriatric populations, and patients with cancer pain and requiring palliative care. The practical recommendations presented in this review for optimal ED pain management in these special populations call for timely, effective, and multimodal analgesia; prioritization of nonpharmacologic and pain syndrome targeted techniques; awareness of drug disease and drug drug interactions; interdisciplinary coordination; and education to mitigate ED clinicians’ biases. This review emphasizes the importance of tailoring pain strategies to population specific needs to improve outcomes, reduce harm, and advance equity in emergency care delivery.

How to cite this article: Vlasica K, Hall A, Rehman MA, Notas G, Shenvi C, Motov S. Emergency department pain management in special populations. Turk J Emerg Med 2025;25:159-77.