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Acute pain is the reason that the majority of patients present to the emergency department.

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Failure to adequately treat acute pain in the emergency department has been labelled a public health problem.

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The College of Emergency Medicine has set standards for the timelines and adequacy in management of pain in both adults and children.

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Joint Care Quality Commission and College of Emergency Medicine national audit demonstrates the gap between standards and current practice.

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The new Department of Health clinical quality indicators for emergency medicine do not include a measure of pain.

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Untreated pain can have short and long term effects, including sensitisation to pain episodes in later life.

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A range of non-pharmacological and pharmacological interventions have been shown to be effective for procedural pain management in infants and children, and are most effective when used in combination.

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Developmental changes in pain responses, analgesic response and drug pharmacokinetics need to be taken into account when planning procedural pain management for neonates.

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Comprehensive evidence based guidelines are available to guide effective procedural pain management in neonates, infants and older children.