Richtlijn ‘Pijnbehandeling bij traumapatiënten in de spoedzorgketen’

Conflict of interest: none declared. Financial support: Development of the guideline was supported by a subsidy from the ZonMw ‘Spoedzorg’ programme (dossier number: 82712002).

• Pain management for trauma patients is a neglected aspect in the chain of emergency care in general practices, ambulance services, mobile trauma teams and in hospital emergency departments.

• The aim of the guideline ‘Pain management for trauma patients in the chain of emergency care’ is to provide pain management recommendations for trauma patients in the chain of emergency care and thereby improve the assistance that patients receive.

• Paracetamol is the treatment of choice, if necessary with additional use of NSAIDs or opioids; NSAIDs can be administered in the absence of contra-indications, but should be avoided in cases where the patient history is unknown; fentanyl and morphine can be given for severe pain during emergency care, esketamine can be considered in patients with severe pain and hypovolemia.

• The guideline contains 3 algorithms for measuring pain and for its pharmacological treatment in the chain of emergency care.

• Implementation of the algorithms requires an alternative working procedure; pain scores must be documented, and general practitioners and nursing staff may administer opioids intravenously.