Emergency Care Acute Pain Management Manual (please see patient factsheets for management of acute pain in ED)
The National Institute of Clinical Studies (2011), National Health and Medical Research Council.
This resource outlines evidence-based clinical assessment and management of some of the more common paediatric and adult pain-associated conditions in the Emergency Department.
Local Anaesthetics in the ED
For information on local anaesthetic procedures in the ED see the ECI developed tools here.
Procedural Sedation in the ED
For information on procedural sedation in the ED see the ECI developed tools here.
Chronic Pain in the ED
The ACI Pain Management Network in collaboration with the ECI have developed a suite of resources to support the management of chronic pain in the emergency department. This can be accessed here.
The ECI ED Leadership Forum on 9 June 2017 had a session devoted to Chronic Pain in the ED, with expert insights from members of the ACI Pain Network. You can see their presentations below:
- Quantifying the problem - Paul Wildin, Manager Frequent User Implementation, NSW Ambulance
- The problem, the project and the outcomes - Paul Wrigley, Senior Staff Specialist Pain Medicine, Royal North Shore Hospital
- Success story at John Hunter Hospital - Fiona Hodson, Pain CNC, John Hunter Hospital
- ED perspective and wrap-up - John Mackenzie, ECI Medical Project Officer
- Panel Discussion
Children and Infants
Management of Acute and Procedural Pain in the ED, (PD2016_0009, NSW Health, 2016)
- Quick link to one page summary
- Full document
- Implementation Toolkit
- Audit Tool
Older persons with hip fractures
The ACI has been working with St Vincent’s Hospital on the development of a support package for the implementation of Fascia Iliaca Blocks (FIB) for hip fracture in the older person admitted to the ED. This work is currently out for consultation. The FIB toolkit has been developed through a clinical review process involving the Aged Health Network, Anaesthesia Perioperative Care Network, Pain Management Network, Emergency Care institute and Surgical Services Taskforce.
There is strong evidence supporting this approach as best practice in the older population. We believe that routine adoption of RIB in Emergency using the competency training framework will improve pain management and minimise complications associated with opioid use, including minimising the risk of delirium.
This work aligns with the ACI Minimum Standards for the Management of Hip Fracture in the Older person and care of Confused Hospitalised Older Persons (CHOPs) Program.
The support package includes:
- Implementation guide
- Explanatory notes
- Video material on how to conduct the procedures
- Competency and training materials
- Audit tool
When this document is finalised the new tools will be vailable here. To provide comments please email firstname.lastname@example.org.
Pain Relief in Breastfeeding Mothers
Guideline developed by the US Department of Health and Human Services - Analgesia and anaesthesia for the breastfeeding mother (revised 2012)
Acute Low Back Pain
The ECI has developed a resource for the management of acute low back pain. These can be viewed here.
The ECI has developed some useful tools on headaches. These can be viewed here.
Further References and Resources
Information Bulletin - IB2017_043 - Up-scheduling of over-the-counter codeine-containing medicines
To inform staff in public health facilities of the up-scheduling of over-the-counter (OTC) low-dose codeine-containing medicines to Schedule 4 (prescription-only) of the NSW Poisons List from 1 February 2018.
Journals and Presentations
- Tobias JD et al. (2016) Codeine: Time to Say "No", Pediatrics, October 2016, vol. 138, no. 4, DOI: 10.1542/peds.2016-2396.
- Chan, Betty - Leadership Forum Presentation, 5 August 2016 - Sedation of the acute behaviourally disordered patient: not settled. yet?
- Cameron, P. (2016) Analgesia in the ED, Emergency Physicians International, 6 October 2016.
- Davenport, K and Waine, E (2010) The Role of Non-Steroidal Anti-Inflammatory Drugs in Renal Colic, Pharmaceuticals (Basel), vol. 3, no. 5, pp. 1304-1310.
Relevant Patient Factsheets
Pain Relief and Oral Opioids - Dr Betty Chan at the ECI Emergency Care Symposium 2015