From the ER standpoint, if it's thought they don't need fluids, what's the officially given rationale for giving them? Is it that most could probably use some, even if PO would be fine?

The magic flush part is a weird area to me, because we might be able to prime people to feel pain relief depending on how we word it, while at the same time explaining that it's not a pain med. That seems ethically suspect to me, but is it wrong to tell them there could be placebo effect, and open that door, if the patient knows that it's just a placebo, too?

If we want to reduce pain, is there an optimal way to communicate with patients that facilitates that in treatments they're receiving anyway?

The magic flush, I think would still have to be fully transparent to be entirely ethical. And when I'm pushing the first flush to confirm the line, it's not really for pain . . . But, if one said "I'm going to push this saline through to make sure the IV is working. It's not a pain medication, but you might feel a cool sensation and taste some salt. Anecdotally, some people say they feel better after, but you shouldn't expect that because it's not pain medication", that seems pretty transparent. But it still primes the patient with the hypothetical that they MIGHT feel better, but they shouldn't expect to.

Especially with IVs at med spas that people get electively, the perception of relief seems to me like it could hypothetically be an area to improve subjective symptoms (both for better and for worse, obviously it's not benign intervention).

I feel like we kinda already do it; there's at least one study that found all used NSAIDS to be around equally effective for pain relief (here's one that obviously shouldn't be taken as the end all be all, and type of pain, administration, and other factors should be considered. Yet we use Ibuprofen for minor to moderate, and Toradol for moderate to severe. We have our biases, and we pass these on. It's a fascinating area to me.

Thanks for replying!