Pain is one of the most immediate and universal experiences of trauma, yet in emergency and pre-hospital care, it remains surprisingly under-treated. Despite decades of awareness, oligoanalgesia, the inadequate treatment of acute pain, continues to affect patients in the very moments when compassionate, effective care matters most. Too often, the focus in emergency systems has been on processes: whether a drug was given, which medication was used, or how quickly it was administered. But from the patient’s perspective, the real question is much simpler: did their pain actually get better?
In this episode, we explore a powerful shift in thinking: what if pain management wasn’t something that happened later in care, but something that started immediately, from the very first patient contact? What if analgesia were treated as a core patient-centred outcome rather than an optional add-on?
Joining us today are Luca Carenzo and Urs Pietsch, whose recent editorial challenges us to rethink how and when we deliver analgesia in trauma. We’ll discuss the concept of “pain first,” the growing role of non-intravenous analgesics such as transmucosal fentanyl and inhaled agents, and what this means for paramedics, HEMS teams, and pre-hospital systems worldwide. Find the editorial here: https://pubmed.ncbi.nlm.nih.gov/41673878/
This episode is sponsored by PAX: The gold standard in emergency response bags.
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