Pain treatment in emergency services

The treatment of pain in emergency medicine is crucial due to the resulting pathophysiological reactions. In order to study this, we questioned 230 emergency doctors with respect to the analgesics used and the treatment of 6 frequently encountered emergency situations. 44% of the emergency doctors had a restrictive attitude towards the use of analgesics in resi cue service. Ketamine was the most frequently used analgesic. The frequency of use even increased from 79 to 96% for doctors who had worked for longer periods in rescue service. Piritramid was the least frequently used analgesic (17%). Pentanyl was most often used by anaesthesiol ogists (75%) and general practicioners (86%). In cases of head injury (62%) and polytrauma (60%) fentanyl was favoured as analgesic, whereas in cases of burns ketamine (48%) and fentanyl (37%) are about equally frequently used. Morphine is preferred for pulmonary embolism (68%) and myocardial infarction (72%). Tramadol has lost the leading position as analgesic in emergency and is now used by only 28% of the emergency doctors. The consequent treatment of pain is not only a necessity from a medical point of view, but should obtain from a humanitarian point of view a higher rating in emergency medicine than it has now.