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In the United States of America, acute pain and the expectation of pain management is one of the primary reasons that prehospital providers receive calls. By definition from the International Association for the Study of Pain, "Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage." As such, pain or the perception of pain can have both physiological and psychological impact on patients that interferes with their activities of daily living, causes a delay in healing and recovery, and ultimately impacting the quality of life of the patient.[1][2] Based upon NEMSIS v2, 33.1% of the complaints to 911 are for pain-related syndromes, with chest pain accounting for 10.2% of all calls.[3][4] The most common provider impression based upon this 2016 data includes traumatic injuries at 21.8%, abdominal pain at 12.2%, and chest pain at 10%. This data means that almost half of all provider impressions are dealing with some form of a pain-related syndrome. A similar study looking at the national electronic prehospital patient records of 41,241 patients transported by emergency medical services (EMS) providers in Denmark showed a 28% moderate or severe pain level with an additional 32% of unknown pain status.[5] Galinski et al., in the prevalence and management of acute pain in the prehospital emergency medicine, indicated that 42% of the individuals having acute pain, with 64% of those patients having intense to severe pain.[6] The National Association of EMS Physicians (NAEMSP) believes that relieving the pain and suffering of patients is of necessity a priority for every EMS system. The 2018 EMS Scope of Practice Model looked at pain management for acute traumatic events as a high-priority issue requiring a systematic review of the literature.

In the United States of America, acute pain and the expectation of pain management is one of the primary reasons that prehospital providers receive calls. By definition from the International Association for the Study of Pain, "Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage." As such, pain or the perception of pain can have both physiological and psychological impact on patients that interferes with their activities of daily living, causes a delay in healing and recovery, and ultimately impacting the quality of life of the patient.[1][2] Based upon NEMSIS v2, 33.1% of the complaints to 911 are for pain-related syndromes, with chest pain accounting for 10.2% of all calls.[3][4] The most common provider impression based upon this 2016 data includes traumatic injuries at 21.8%, abdominal pain at 12.2%, and chest pain at 10%. This data means that almost half of all provider impressions are dealing with some form of a pain-related syndrome. A similar study looking at the national electronic prehospital patient records of 41,241 patients transported by emergency medical services (EMS) providers in Denmark showed a 28% moderate or severe pain level with an additional 32% of unknown pain status.[5] Galinski et al., in the prevalence and management of acute pain in the prehospital emergency medicine, indicated that 42% of the individuals having acute pain, with 64% of those patients having intense to severe pain.[6] The National Association of EMS Physicians (NAEMSP) believes that relieving the pain and suffering of patients is of necessity a priority for every EMS system. The 2018 EMS Scope of Practice Model looked at pain management for acute traumatic events as a high-priority issue requiring a systematic review of the literature. Prehospital providers have to perform appropriate pain assessments and understand options for the treatment of acute pain. Pain assessment and treatment can be difficult based upon several different factors, including patient's age, race, location, EMS provider's ability or reluctance to administer pain medication, and the medical director's authority on the administration of pain medication. There is also a growing concern that the administration of opiate or opioid medication will cause addiction and abuse. One of the major hurdles for pain medication administration in the United States before 2014 was that prehospital providers would use standing orders to administer controlled substances for pain control. This administration of pain medication was based upon the 1970 Controlled Substances Act with an interpretation that EMS providers were allowed to administer pain medication under the DEA registration of the medical director or hospital system. The DEA rejected standing orders for controlled substances for prehospital providers. Congress passed the Protecting Patient Access to Emergency Medications Act of 2017, which modified the Controlled Substances Act of 1970 to allow for EMS agencies to be registered with the DEA and use standing orders. The Act also gives specific instructions on the storage of controlled substances, provides for the restocking of EMS vehicles at hospitals, requires maintenance of controlled substance records, and holds the EMS agency liable for controlled substances.