Pain Service and Pre-Surgical

Patient Care and Medical Knowledge Focus

Develop proficiency in performing a Pain Management Consult in children with:

• acute post-surgical or post-traumatic pain
• acute medical pain
• chronic medical or traumatic pain such as neuropathic pain
• opioid/benzodiazepine weaning for physiologic dependence
• develop proficiency in using the pain management modalities of:
  • intravenous patient-controlled analgesia
  • epidural analgesia
  • peripheral nerve blocks both single-dose and continuous infusion
  • intravenous, oral, and alternate routes for spectrum of opioid, NSAID, benzodiazepine, and sympathomimetic and neuropathic analgesic drugs
  • converting from intravenous or regional modalities to oral analgesics
• more rarely, be familiar with indications for initiation of intrathecal opioid/local anesthetic analgesia for terminal pain (in liaison with neurosurgery)

Practice-Based Learning and Improvement

• become familiar with pediatric pain management resources including textbooks, journals, and computer-based search resources
• become familiar with multi-disciplinary resources in pediatric pain management including general and hospitalist pediatrics, rehabilitation medicine, neurology, psychiatry/behavioral medicine, oncology, neurosurgery

Systems-Based Practice

Become familiar with basic mechanics of an inpatient pediatric pain service including staffing & call coverage, protocols, nursing education, relevant policies and procedures.

Professionalism

Be respectful to patients, parents, and staff Be punctual for rounds, timely in performing consults, and diligent in follow-up of pain management interventions.

Presurgical Clinic/Medical Knowledge and Patient Care

• develop proficiency in acting as consultant in presurgical evaluation of children
• evaluating acute conditions affecting readiness for anesthesia and surgery
• evaluating consultant information and need for additional consultation or clarification

Systems-Based Practice

Become familiar with the basic components of a Presurgical Clinic structure, including staffing make-up, physical space, patient flow and scheduling, and protocols of communication

Practice-Based learning and Improvement

Choose medically complex patients to discuss at the weekly Presurgical Medically Complex conference on Thursdays 4 PM.  This is to be done in liaison with weekly attending.

Professionalism

• respond to Presurgical Clinic consults in prompt manner
• be respectful of patients, parents, and staff at all times
• take time to fully explain issues with patients and families in understandable manner