• Management of pain must be placed in the context of the clinical presentation and take into consideration whether it is acute vs chronic, and whether the pathway is nociceptive vs neuropathic.
  
  
• Underlying mechanism of pain impacts approach to managing the pain.
  
  
• Pain treatment should not be delayed pending a diagnosis.
  
  
• IV titration is generally the preferred approach for severe pain and should incorporate the concepts of treat early, and follow with a strategy to prevent recurrence.
  
  
• Opioids are not always best analgesics; NSAIDs are not benign; all analgesic treatment should incorporate consideration for anxiolysis and suggestion.
  
  

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• What is the best initial analgesic for nociceptive pain?
  
  
• What is the best initial analgesic for neuropathic patient?
  
  
• Can intranasal, transdermal, or intramuscular delivery systems provide analgesia as quickly as intravenous delivery?
  
  
• Can care maps / practice guidelines change analgesic management practice in the ED?
  
  
• What is the role for alternative therapies in pain management?
  
  

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