Acute Pain – Logistics

• Fellowship Director: Brinda Kamdar, M.D.
• Division Lead: Yi Zhang, M.D.

Morning Sign-in & Rounds:

• Being at 8am in Wang 330 where you receive sign out from the overnight resident and plan for rounds for the day.

Afternoon Sign-out:

• Typically held at 5pm but may change based on workload and scheduled procedures.
• The on-call resident will receive the APS pager after sign out.  DO NOT SIGN THE PAGER TO YOUR OWN PERSONAL PAGER AT ANY TIME.

All patients will be seen daily with documentation for each visit.

Initial Consultations

• When called determine the nature of the consult, whether Acute or Chronic.  If Chronic, take down patient information and then contact the Chronic team directly to transfer the consult.
• All new consult notes should be typed into Epic using the Inpatient Pain Service Consult template.  Consults should be completed by the end of the business day.

Follow up Visits

• All APS follow up visits should be documented using the APS daily progress note template.

Orders

• If the patient is on a SURGICAL primary service, the Acute Pain team may change orders, but must page the responding clinical to inform them of the change.
• If the patients in on a MEDICINE/PEDIATRIC primary service, the Acute Pain may leave recommendations and inform the team, but may not make changes.

Sign-Off Notes

• If signing off on a patient, complete the sign-off note in Epic as early in the day as possible.
• Use the APS sign off template.
• Give recommendations to taper narcotics, if applicable.

1. Residents will take Acute Pain in-house 24-hour call during their month on the Acute Pain.
2. The Acute Pain resident on call serves as the backup for the obstetric anesthesia service overnight.  OB Backup starts at 11pm on Monday-Friday and on 7pm on weekends and holidays.
3. The Acute Pain resident on call reports to Blake 14 to get sign-out and leave his or her pager number on the dry erase board.
4. As OB Backup, you should alert the OB team when you leave Blake 15  (to check on a patient or see a consult).
5. If you anticipate that you will be gone for a prolonged period (placing an epidural or administering a bolus), inform the OB resident and the MOR first call resident, who will in turn be immediately avaialble to respond to the OB floor for emergencies.

Location and topics to be determined by Acute Pain call attending of the week

1. Resident education must include one month in an acute peri-operative pain management rotation.
2. Resident experience must involve care for 20 patients presenting for initial evaluation for pain.  This requirement may also be met during the Chronic Pain rotation.