Summary Writer: Nicholas Malouf
Editor: John-Paul Favero
Interviewee: Tim Suharto
James talks to Dr Tim Suharto about acute pain management in the first of a two part series.
Tim is a specialist anaesthetist and one of the supervisors of training at Nepean Hospital. He is involved in the anaesthetic education program and leads the Group for Anaesthetic Simulation (GAS), which delivers in-situ crisis scenarios involving critical care doctors and nurses. Tim is an instructor for the Nepean Difficult Airway course as well as the Nepean Can’t Intubate Can’t Oxygenate (CICO) workshop. He is a strong advocate for innovation in medical education and developing links between sub-specialties in medicine to enhance understanding and collaboration.
Tim’s clinical work encompasses both public and private practice with regular sessions in acute pain medicine, anaesthesia for orthopaedics, ENT, neurosurgery and interventional radiological procedures.
With DrTim Suharto, Staff Specialist Anaesthetist at Nepean Hospital, New South Wales, Australia
Pain can be classified into several categories: acute, chronic, cancer-related, and neuropathic. In 1986 World Health Organization (WHO) devised a step-wise approach to pain management. Although this still has merit, in recent years pain management has developed a mechanistic approach tailored to the type of pain. Junior doctors regularly make decisions relating to the management of acute pain with opioids being a mainstay. It is important to be able to prescribe opioids safely and confidently.
Types of Pain
These include: Acute vs Chronic
Pathophysiological classification of pain
Case – A 70 year old woman is admitted from the Emergency Department with a neck of femur fracture. She is to be transferred to the ward to await surgery (likely nil by mouth) and you are asked to prescribe analgesia for when she goes to the ward.
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