Seventy per cent of patients who present to the ED have pain as their main complaint—and most of the time as a sign of injury or inflammation. Therefore, early assessment by scoring at the point of triage and offering the appropriate analgesia are the first steps towards the management of such patients. The College of Emergency Medicine guidelines suggest that at least 98% of patients in severe pain (pain score of 7–10) should be offered appropriate analgesia within 60min of arrival, or triage, whichever is earlier. In 90% of these patients, the status of pain should be re-evaluated within 60min of receiving the first dose of the analgesic. Despite this clear-cut standard and the availability of a wide variety of analgesics, achieving such a target remains, occasionally, elusive. It must also be realized that a positive experience for the patient largely depends on relief of pain as early as possible. Consequently, one of the primary areas for a new FY1 to focus on is the pain management. Remember it is simple and straightforward in most circumstances. GA may be required in the ED for various clinical indications, for example, cardioversion, facial trauma or burns, and acute respiratory failure (such as in asthma). In an emergency situation it may be a challenging procedure even for an experienced anaesthetist and could be dangerous for the patients. An FY1/2 will never be expected to perform this, but it is important to know when to call for help when the situation demands. Local anaesthesia is widely used in the ED, and is one of the skills foundation trainees learn in the early days. It is comparatively safe if the doctor is aware of how to perform the procedure and the upper limit of the dose for a particular patient. Finally, conscious sedation is also widely used in the ED for reducing fractures and/or dislocations and minor operations. However, it carries the same risks as GA and should be carried out by a doctor who is trained in the procedure as well as in resuscitation. A risk assessment should be performed as a patient with high risks (previous cardiac or respiratory diseases) must be sedated with extreme caution.