Refers to severe pain, uncontrolled that is causing the patient and family or both severe distress.
Pain may be acute or may have increased to intolerable levels, but requires immediate management.
Pain severe rated at least 7 on a 10 point scale and requires rapid opioid treatment.
In patients who have not been exposed to opioids morphine is generally considered the standard starting agent of choice.
For patients with hepatic or renal insufficiency hydromorphone or fentanyl, with short-half lives, are appropriate choices.