see also:

• EM nursing
• nurse initiated ED treatment
• ED nurse initiated analgesia
• Western Health policies (intranet only):
  • Nurse initiated procedures
  • Nurse Initiated X-rays
  • Nurse Initiated Intravenous Opioid Analgesia Standing Orders

• patients with severe back pain can be initially managed in Fast Track if clinically stable and some may require admission to EOU once red flags have been excluded
• their length of stay in ED could be reduced and their symptoms partly relieved by nurse initiated ED Rx, although it is recognised that these presentations can be complex and warrant timely medical assessment to properly exclude important red flags.
• the following is a suggested framework for ED's who have nurses accredited to undertake ED nurse initiated treatment including the ordering of pathology tests.

• see also: basic nursing assessment common to all pathways

• see also: back pain in the ED

• new neurology
• upper abdominal pain (need to consider abdominal aortic aneurysm (AAA))
• hypotension
• severe pain
• pregnancy

• urinalysis with MSU m/c/s
• oral analgesics such as paracetamol, oxycodone, non-steroidal anti-inflammatory drugs (NSAIDs)
• if possible a trolley to lie on as sitting may exacerbate the pain