With regard to patients with chest injury, the earlier pain is controlled, the less likely patients will suffer complications from inadequate pain control, splinting OR excessive narcotisation. This is especially the important in elderly patients and patients with significant comorbidities. There is an agreement at SCGH between Pain Service, Trauma Service and the ED, that any patient with the following criteria should be referred to the Acute Pain Service (which is available for referral 24/7).
Criteria for urgent referral to acute pain team:
- > 65 years old
- significant comorbidities
- no enteral route available
- > 2 rib fractures.
The Acute pain team page 4120 during normal working hours (CNS) and page 4823 (anaes reg) after hours/ weekends.
For additional information:
- Here is a good summary of Analgesia in Chest Trauma and an associated post on Thoracic Epidural Analgesia for Chest Trauma from LITFL
- From the NYSORA website: