acute pain services for inpatients at Epsom and St Helier hospitals

Pain services for inpatients (Inpatient/acute pain service)

Our inpatient/acute pain service is consultant nurse led service, providing support to patients who are in hospital. Most of the patients we see have had surgery but we also see patients who have other acute pain problems not involving surgery and those who have flare ups of more long term conditions such as back pain.

We see patients on the wards, in the intensive care/high dependency units and in our emergency departments.

We carry out a ward round every weekday morning, visiting you at your bedside. We will talk to you about your pain and check and revise your pain medicines if appropriate.

A large part of our role lies within education and we spend significant time teaching nurses, doctors, students, physiotherapists and other staff, on the management of pain in hospital.

The department can:

Provide expert pain management advice to patients and staff
Ensure that techniques for managing pain are used safely and effectively
Support staff through education and training to help improve the management of pain for inpatients 24 hours a day, seven days a week
Provide written guidelines for ensuring safe practice, based on the most appropriate and recent evidence.

We see patients:

Who have had major surgery, particularly if they have a PCA or an epidural infusion (see below)
Who have had surgery who are referred to us by their own hospital teams
Who have traumatic injuries such as fractures
With new onset back pain
With flare ups of longer term pain problems such as leg ulcers, pancreatitis, sickle cell pain, and chronic back pain.

How we help with pain management

When we visit you in hospital, we will always introduce ourselves and explain who we are. We will ask you about your pain levels and if these are not acceptable to you, and will review your medicines.

The senior nurses in our team are able to prescribe your pain medicines (known as analgesics) so that we can ensure that you receive the best possible pain relief as quickly as possible. We will also check any equipment that you have for your pain (see patient controlled analgesia and epidural infusions below) and ensure that these are being used safely and effectively

We use different medicines and methods to help you to manage your pain. The method used will depend on the type of pain you have, the cause, the severity and your overall condition. The simplest way to give pain relief is to give medicines by mouth as tablets or liquid. However, this is not always possible and sometimes we will give analgesia in other ways:

Injections – we can give you analgesics as an injection into a muscle or under the skin; this can be useful if you are unable to manage to take tablets or liquids and if you have not got a drip that we can use to give the analgesics intravenously
Patient controlled analgesia (PCA) – this uses a machine that contains a syringe of strong medicine (usually morphine) that is attached to an intravenous drip in your arm. The machine has a handset with a button on it; when you press the button, the machine delivers a small amount of the pain medicine straight into your vein through the drip. The machine is set to allow you to have the medicine once in every five minutes so you cannot overdose yourself
Epidural infusion – an epidural is a way of giving pain relief continuously, using a very small line that is attached to a bag of strong pain medicine which also contains some medicine (local anaesthetic) that will numb the area of your body where you are likely to have pain. The small line is attached to a small plastic tube that is placed in your back by the anaesthetist. The tube is placed in between two of your backbones (vertebrae) into an area called the ‘epidural space’ and once the tube is attached to the fine line, we are able to trickle pain medicine continuously into the space to give you constant pain relief. Read more about epidurals.