Pain management

Pain is a common cause for emergency department visits among patients with cancer. The emergency physician has many medications at their disposal to control pain acutely. Assessment of the cancer patient should be thorough and include documentation of formal pain scale assessments as well as a search for factors that could precipitate an acute pain crisis. Pain should be managed aggressively and reassessed frequently as acute pain syndromes, in particular, may evolve rapidly. Analgesic choices will vary with the clinical situation, but decision-making should incorporate what is understood about the underlying clinical pathophysiology of the malignant process, the current analgesic regimen, as well as pain severity. Finally, it is important to be aware of patient and family goals of care and to engage the oncologic or palliative care team throughout the visit.