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Acute Pain Service

For Patients and Visitors

What is the Acute Pain Service?

We will review and provide advice for patients currently admitted to hospital, who have new onset pain, whether it is surgically related or not, which can not be controlled with oral medications. Not all patients with pain will be reviewed by us, unless it is deemed necessary by the home team. We will review patients until their pain can be managed by more conventional oral means. With certain surgeries and injuries such as rib fractures, Anaesthetics and the Pain Service may be able to assist with peripheral nerve blocks that may improve pain relief and facilitate a more rapid recovery from surgery or injury.

Patients who are nearing end of life may have their pain and other symptoms best managed by the Palliative Care team, as they can provide a more appropriate holistic management plan incorporating a community health link.

What can I expect from the service?

We are an inpatient consultation service only.

If advice is required, the treating team will contact the APS to obtain guidance on pain relief options.

If more complex pain / severe pain is being experienced, we will then review patients daily or as frequently as necessary. Pain is a natural part of the body’s healing process, and whilst we often cannot eliminate pain, we aim to manage it to enable acceptable function.

Contact us:

Referrals are only via the patient’s treating team.

For Health Professionals

Service Overview:

The Acute Pain Service (APS) at The Northern Hospital is run by the Anaesthetic Department. The Acute Pain Service is a consultative service that provides advice to other teams on managing acute episodes of severe pain. Modalities include Patient-Controlled Analgesia (PCA), epidurals, continuous regional anaesthesia and other more specialised forms of pain relief such as ketamine and lignocaine infusions. We also monitor for the rare complications that can occur with regional anaesthesia. We can offer peripheral nerve blocks with ultrasound guidance as a routine anaesthetic technique for those patients having surgery or with certain injuries such as rib fractures. Regional analgesia can facilitate rapid recovery and early mobilisation after surgery or injury.

The APS is also involved in the multi-disciplinary education of staff regarding all aspects of pain management.

Pain rounds are conducted 7 days a week by a team consisting of:

M-F: Anaesthetic Consultant, Clinical Nurse Consultant and Anaesthetic Registrar

Sat/Sun/PHol: Anaesthetic Registrar

Inclusion criteria:

Patients that have failed appropriate conventional multimodal analgesia for acute severe pain. We can provide advice on complex pain syndromes, including neuropathic pain, patients with complex medical problems and opioid tolerant patients. Additionally, we manage advanced analgesia including regional analgesia, Patient Controlled Analgesia (PCA), and ketamine\lignocaine Infusions. We also review patients daily whilst they have a regional anaesthesia technique ongoing, until all effects have worn off, and complications have reasonably been excluded. Additionally, inpatient teams may refer patients whose treatment involves possible severe pain and those at risk of developing chronic pain.

Exclusion criteria:

Patients whose pain is able to be managed with standard oral analgesia. The APS team can assist with advice to deal with drug seeking patients. Patients who are deemed to be palliative should be referred to the Palliative Care team.

How to Refer:

Pain Registrar 24/7 on pager 779 or 8405 8993
Pain Nurse 8405 2779 (Weekdays 8-4pm) 

Referral must include:

An appropriate pain history, treatments attempted and any side effects, current investigations and their results, and a working diagnosis. When patients claim to be on high dose opioids, confirmation of their prescription must have been made with their prescriber and pharmacy.
Pre-referral analgesic guidelines available at:
Please see the Acute Pain Manual on Prompt.

In Hours Enquiries (excluding pt referrals):

Pain Service Clinical Nurse Consultant: Nicole Gauthier on 8405 2779

Anaesthetic Consultants: Jason Ma, Moira Rush, Akilan Velayudhan (via switch)

Location and Hours:

The Northern Hospital Epping

185 Cooper Street Epping, VIC 

Alternative service options:

Persistent Pain Service – if patients have had pain for more than 3 months (contacts for inpatients are as per Acute Pain Service) .

Drug and alcohol service for patients with likely addiction disorders – Alcohol and Other Drugs (AOD) services on 8405 8894.

Palliative Care – for patients experiencing severe symptoms related to advanced serious illness.

Cost:

No cost as it is an inpatient service.

Director/Head of Unit:

Dr Jason Ma

Dr Moira Rush