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It’s 14: 30 on a hot August afternoon in your Emergency Department.
A 46-year-old construction worker presents with sudden, severe right-sided flank pain radiating to the groin.
He is pale, diaphoretic, and vomiting from pain.
Vitals: BP 132/78 mmHg, HR 104 bpm, RR 22, Temp 37.4 °C, SpO₂ 98 % RA.
You diagnose acute right renal colic.
He has already received rectal diclofenac 100 mg and IV paracetamol 1 g and is being moved to a cubicle for IV fluids.
Despite this, his pain remains 10 / 10, and he continues to retch.
You prepare to administer IV morphine for analgesia.
According to the Royal College of Emergency Medicine (RCEM) Best Practice Guideline – Management of Acute Pain in Adults in the Emergency Department (September 2024), which statement best reflects recommended practice for the use of opioids in the ED?

A. Oral preparation is recommended for acute pain control in the ED

B. The routine prescription of an anti-emetic with an opioid is recommended

C. The use of opioids in abdominal pain does hinder the diagnostic process

D. Opioid-seeking behaviour is not uncommon in ED

E. Laxative co-treatment should not be routinely commenced for patients receiving strong opioid analgesia

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References

https://rcem.ac.uk/wp-content/uploads/2024/10/Management_of_Acute_Pain_in_Adults_2024_v1.pdf

Score

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