Referral to the paediatric ACUTE pain service
The Paediatric Pain Management Service provides input and support across the hospital for a child and their family experiencing acute, complex or procedural pain.
Introduction
The Acute Paediatric Pain Management Service provides input and support across the hospital for a child and their family experiencing acute (postoperative and procedural) pain, as well as children requiring a weaning programme for prolonged opioid and benzodiazepine administration.
Post-Operative care
The Paediatric Acute Pain Service receives referrals for the management of acute postoperative pain for a child or young person who is prescribed one or more of the following pain management modalities in the perioperative period:
Patient Controlled Analgesia (PCA)
Nurse Continuous Analgesia (NCA)
Continuous Analgesia Infusion (Ketamine)
Epidural Infusions
Regional Infusions
Prior to discharge from the Post Anaesthetic Care Unit (PACU), a child is referred to the Paediatric Pain Service using the Anaesthesia Information Management System, Safer Sleep®.
A child started on a pain modality by intensive care (PICU) staff or requiring a pain modality on discharge to the ward from PICU should be referred to the Paediatric Pain service using both e-referral on the Regional Clinical Portal (RCP) and by notifying the Pain Service by phoning the pain registrar or pain nurse specialist.
Ward patients
The child's primary consultant should be consulted prior to a pain service referral.
A referral to the Paediatric Pain Service for management of acute pain due to medical conditions should be made by a senior member of the child’s medical team to the Paediatric Pain Service - Inpatient via e-referral on RCP. If urgent/same day review is required the Pain Service should also be contacted directly by phoning the pain registrar or pain nurse specialist.
Referral pathway
Children weaning from opioids and benzodiazepines
Children who have been commenced on a Paediatric Withdrawal Assessment and Prescription (CR8993) form in intensive care (PICU) should be referred by telephone to the Paediatric Pain Service by the PICU registrar prior to the patient leaving PICU
An e-referral form should also be completed through RCP, and a weaning chart should be completed online via the intranet at https://mcshaz.github.io/PicuDrugsClient/#/withdrawal. The weaning remains the responsibility of PICU until a formal handover have been received via phone call and e-referral.
Procedural pain
The pain nurse specialists can be contacted Monday to Friday to provide support and advice for pharmacological and non-pharmacological options. A child in hospital is often subjected to frightening and painful procedures and the pain nurse specialists can offer advice or assistance to a child, caregivers and medical colleagues.
Discharge
A child is discharged from the Paediatric Pain Service to the primary medical team once the pain management modality or the medication wean has been discontinued. The primary medical team will then take over responsibility of the prescribed analgesic regimen.
A referral of a child with a complex or persistent pain condition has a separate referral pathway. See Starship Guideline on Referral to the Complex Pain Service