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Studies show that acute pain is poorly managed in many emergency departments (EDs). Researchers at an urban ED randomized 350 patients (age range, 21–64; weight ≥150 lb) with acute pain to receive 2 mg intravenous hydromorphone or usual care (use of any IV opioid at the discretion of the treating physician). Total doses were measured in morphine equivalent units (MEUs); 1 mg morphine equals 1 MEU and 1 mg hydromorphone equals 7 MEUs. All patients in both groups received oxygen by nasal cannula.
The primary efficacy outcome was the proportion of patients who declined additional analgesia 30 minutes after the initial dose, when asked “Do you want more pain medicine?” The primary safety outcome was use of naloxone.
Significantly more patients in…