What we do

• Acute Pain Service
• Complex Pain Service

• The APS is an inpatient service provided by a team that includes physician anesthesiologists and a pain nurse clinician who work with other health care professionals (physicians from other disciplines, nurses, pharmacists, child-life therapists, psychiatrists, psychologists and physiotherapists) in the management of pain in children from birth to 18 years. 
• The APS team is dedicated to the prevention and treatment of pain in hospitalized children.
• Many of the children followed by the APS have had surgery while others have ongoing complicated pain problems resulting from chronic diseases, cancer, trauma or burn injuries.

How does the APS help?

The APS aims to provide maximum comfort with minimum risk or side-effects.

The APS provides advanced pain management techniques including:

• continuous opioid infusion 
• patient controlled analgesia (pain relief) 
• local anaesthetic techniques 
• regional techniques such as continuous epidural analgesia

The APS takes a lead role in the provision of sedation and pain relief for procedures such as:

• lumbar (lower back) puncture
• bone marrow aspiration
• burn baths and dressing change
• fracture reduction/setting 

The APS also provides advice to patients, families and health care professionals about the best use of medications in the management of children’s pain.

How are patients referred to the APS?

• Children’s Hospital inpatients experiencing acute pain can be referred to the APS by the attending physician, fellow, resident or clinical clerk.
• For children having surgery, referrals are often decided upon prior to, or at the time of, surgery, following consultation between the surgeon, anesthesiologist and patient/family.
• The APS on-call physician can be contacted through the hospital paging system (local 2161) or by paging the APS Nurse Clinician at 410-2196.

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Complex Pain Service (CPS)

What is the CPS?

• The CPS is an innovative outpatient service provided by an interdisciplinary team that includes a pediatrician, anesthesiologist, pain nurse clinician, psychologist and physiotherapist. 
• The CPS team is dedicated to the prevention and management of complex pain in children and youth.
• Some of the common types of pain we treat are headaches, abdominal and musculoskeletal pain.
• A psychiatrist and pharmacist are available to assist the CPS team as needed.

How does the CPS help?

The CPS aims to improve everyday functioning and overall well-being by reducing the impact of pain on all aspects of the child’s life.

This is achieved by:

• promoting and supporting a self-management approach 
• implementing a treatment plan in collaboration with the child and family that includes one or any combination of the following: 
• medication
• physical therapy 
• cognitive behavioural therapy
• complementary therapy
• local anesthetic intervention 
• focusing treatment on physical reconditioning and coping techniques as well as family and educational support
• providing treatment on an outpatient basis
• referring the child and family back to the community for care, once a workable treatment plan has been established

More information on the CPS Clinic is available in our Complex Pain Service pamphlet (PDF).

How are patients referred to the CPS?

• Children and adolescents under age 17 with complex chronic pain conditions can be referred to the CPS by any physician involved in their care.
• The CPS Referral Form  is to be completed by the referring physician and faxed, along with a referral letter and relevant reports, to the CPS (see the Contact us page for more information).
• Referrals are processed in the order they are received; they are then triaged by the CPS team.

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Updated: October 4, 2011