Acute pain management in emergency settings in 2024: Formalized expert recommendations from the French Society for Emergency Medicine
Villoing, B.
Acute pain management in emergency settings in 2024: Formalized expert recommendations from the French Society for Emergency Medicine - 2025.
44
Objective To provide updated guidelines for the management of acute pain in adult patients in emergency settings. Design A consensus committee of 31 experts from the French Society for Emergency Medicine (Société française de médecine d’urgence, SFMU), including 10 pain specialists (with national/international publications), was convened. A formal conflict-of-interest (COI) policy was developed at the beginning of the process and enforced throughout. The entire guideline construction process was conducted independently of any industrial funding (i.e., pharmaceutical, medical devices). The authors were required to follow the rules of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence. Methods The aim of this expert panel was to evaluate the medical treatment of acute pain in emergency care settings both inside and outside of hospitals. The experts explored questions within three domains: 1) indication for analgesic treatment following pain assessment and the organization of the health care teams; 2) pharmacological and non-pharmacological management; and 3) continuation of analgesic treatment following discharge from the emergency department or during hospital admission. Each question was formulated according to the PICO (Patients Intervention Comparison Outcome) model, and corresponding evidence profiles were produced. Based on these clinical questions, an extensive bibliographical search over the last 20 years was carried out using predefined keywords in accordance with PRISMA recommendations. Data quality was analyzed using the GRADE method. Recommendations were then formulated using the GRADE method and voted on by all the experts according to the GRADE Grid method. Results The experts’ synthesis work and the application of the GRADE® method resulted in 35 recommendations and 1 diagram. After 2 rounds of voting and several amendments, strong consensus was reached for all the recommendations. Among the formalized recommendations, 5 have high levels of evidence (GRADE 1) and 13 have low levels of evidence (GRADE 2). For 17 recommendations, the GRADE method could not be applied, resulting in expert opinions. For 4 questions, no recommendation could be made due to a lack of available data. Conclusions: There was strong expert consensus on 35 recommendations to improve the management of acute pain in adult patients in emergency settings.
Acute pain management in emergency settings in 2024: Formalized expert recommendations from the French Society for Emergency Medicine - 2025.
44
Objective To provide updated guidelines for the management of acute pain in adult patients in emergency settings. Design A consensus committee of 31 experts from the French Society for Emergency Medicine (Société française de médecine d’urgence, SFMU), including 10 pain specialists (with national/international publications), was convened. A formal conflict-of-interest (COI) policy was developed at the beginning of the process and enforced throughout. The entire guideline construction process was conducted independently of any industrial funding (i.e., pharmaceutical, medical devices). The authors were required to follow the rules of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence. Methods The aim of this expert panel was to evaluate the medical treatment of acute pain in emergency care settings both inside and outside of hospitals. The experts explored questions within three domains: 1) indication for analgesic treatment following pain assessment and the organization of the health care teams; 2) pharmacological and non-pharmacological management; and 3) continuation of analgesic treatment following discharge from the emergency department or during hospital admission. Each question was formulated according to the PICO (Patients Intervention Comparison Outcome) model, and corresponding evidence profiles were produced. Based on these clinical questions, an extensive bibliographical search over the last 20 years was carried out using predefined keywords in accordance with PRISMA recommendations. Data quality was analyzed using the GRADE method. Recommendations were then formulated using the GRADE method and voted on by all the experts according to the GRADE Grid method. Results The experts’ synthesis work and the application of the GRADE® method resulted in 35 recommendations and 1 diagram. After 2 rounds of voting and several amendments, strong consensus was reached for all the recommendations. Among the formalized recommendations, 5 have high levels of evidence (GRADE 1) and 13 have low levels of evidence (GRADE 2). For 17 recommendations, the GRADE method could not be applied, resulting in expert opinions. For 4 questions, no recommendation could be made due to a lack of available data. Conclusions: There was strong expert consensus on 35 recommendations to improve the management of acute pain in adult patients in emergency settings.
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