Effectively Managing Pain in the ED without Opioids

The U.S. is facing an opioid epidemic, with increasing numbers of patients who are addicted and overdosing on opioids. Kaiser South San Francisco Emergency Department undertook a multiyear journey to progressively decrease the number of opioids used for pain. Data and clinician feedback were used to evaluate the effectiveness of interventions such as safe prescribing practice guidelines, IV Tylenol for acute pain, and guidelines for the management of chronic pain.


  • 59% reduction in parental opioid use with IV Tylenol.
  • 33% decrease in inpatient LOS and 28% reduction in inpatient delirium with opioid avoidance.
  • 25% decrease in ED LOS with IV Tylenol.
  • 52% reduction in opioids prescribed for chronic pain.


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