Justin Walford asks whether the use of opiates can be kept to a minimum even in patients with isolated limb trauma and high initial pain scores

One of the main complaints from patients who present to emergency departments with illness or injury is pain, yet often this is not well managed in emergency settings. Nurse prescribers are in an ideal position to make a rapid assessment and then prescribe and treat patients’ pain, and must quickly decide which is the safest and most effective drug for each individual. This article compares intravenous morphine with intravenous paracetamol for managing pain in patients with isolated limb trauma who then require manipulation under sedation. A case study examines the decision-making process.