- Professor Dominic Harmon, Director of Pain Services Pain Medicine Consultant/Anaesthetist.
- Pain Registrar/SHO/Trainees on two monthly rotation.
- Ms. Mary Merrick, Clinical Nurse Specialist (CNS) Acute Pain (bleep 420).
- Ms. Alison Burgess, Clinical Nurse Specialist (CNS) Chronic Pain (bleep 330).
- Dr Pat Ryan, Liaison Clinical Psychologist.
- Antoinette, Pain Secretary UHL Ex 061 485336.
- Catherine/Lillian, Anaesthetic Secretary UHL Ex 061 482591.
Description of Service
We plan and implement care and treatment options for adults and children experiencing acute and/or chronic pain..
Acute Pain Service
Our Acute Pain Service includes an established service for adults and children, which provides day to day management of acute pain throughout the hospital. A CNS undertakes the acute pain ward round daily from Monday to Friday. The purpose is to provide expert advice on the management of acute pain and to review all patients who are using patient controlled analgesia (PCA), patient controlled epidural analgesia, (PCEA), peripheral nerve blocks (PNB), including pharmacologic management of complex pain conditions. The anaesthetist SHO on call covers the acute pain round during the weekend and out of hours. We work in conjunction with pharmacy and physiotherapy. We also work closely with the pain services in St John’s Hospital Limerick and with Palliative care services in Milford Hospice Limerick.
Chronic Pain Service
Our Chronic Pain Service is available to in-patients at University Hospital Limerick (UHL) with patients being referred to the service usually by the primary team from all disciplines. We aim to provide timely assessment of patient’s pain within 24 hours of receiving the referral for both acute and chronic pain conditions. The service also provides expert advice and input to more difficult to manage conditions on surgical, medical and palliative care settings
Chronic Pain Clinic
In Medicine, we recognise that some forms of chronic pain are not easily treated with standard drug therapy. Diagnosis of the mechanism of pain is paramount as is understanding the effects pain has on the patient and their families’ lives. We aim to help people manage their pain and improve their quality of life by teaching them self management coping strategies. Acceptance Commitment Therapy (ACT) and Motivational Interviewing (MI) are used as part of the self- management process. Our chronic pain clinic is based in the UHL and associated sites, including Croom hospital. Services include, weekly clinics, intervention lists and ward referrals. The key to a positive treatment outcome is patient engagement, involvement and empowerment. Following assessment, each patient will have a treatment plan which may involve e.g. nerve block injections, medication management and non-pharmacological therapies such as: hydrotherapy, and relaxation exercises. For those needing more input, an individualised Pain Management programme is available every 2nd and 4th Wednesday afternoon. Our Liaison Clinical Psychologist has clinics every 2nd and 4th Monday afternoon in OPD. The team are able to offer most treatment options at a local level and endeavour to work closely with GPs to facilitate patient care.
Outpatient Clinic Times
Pain Clinic Rota
|Pain Psychology Clinic - Dr Pat Ryan, UHL, Dooradoyle, Limerick
||2nd and 4th Monday pm OPD Suite 2 UHL
|OPD clinic - Dr Conroy, St John’s Hospital, Limerick
||Monday am, St John’s Hospital
|Intervention List - Prof Harmon, Croom Hospital, Limerick
||Tuesday am Day Ward UHL
|Pain Clinic Programme - Prof Harmon, UHL, Dooradoyle, Limerick
||2nd and 4th Wednesdays pm OPD Suite2
|Intervention List - Dr Conroy, St John’s Hospital, Limerick
||Thursday pm Theatre St John’s Hospital
|Intervention List - Prof Harmon, Croom Hospital, Limerick
||Alt Thursday am Recovery Room Croom Hospital
|Outpatient Pain Clinic - Prof Harmon, UHL, Dooradoyle, Limerick
||Friday pm OPD Suite1 UHL
Types of pain conditions
- Musculoskeletal Pain
- Post Surgical Pain/Persistent Post Surgical Pain
- Peripheral Neuropathy
- Idiopathic Pain Occurring from Medically Unexplained Reasons
- Peripheral Nerve Pain
- Myofascial Pain
- Neuropathic Pain
- Visceral Pain
Key treatment options
- Biopsychosocial and mechanical assessment
- Investigations (CT/MRI/USS)
- Individualised education regarding specific acute and chronic pain syndromes
- Comprehensive assessments using ACT and MI
- Pain nerve block procedures for diagnostic and therapeutic purposes
- Interventional procedures including Qutenza patch application
- Medication management
- Physical therapy
- Psychological support
- Hydrotherapy supported by St Gabriel’s Limerick and St Joseph’s Charleville
- Meditation, progressive muscle relaxation and relaxation therapies
- Mindfulness eight week programme
- Transcutaneous Electrical Nerve Stimulation TEN’s therapy
How to access the Service
Our chronic pain service can be accessed either by GP referral or by speciality consultant referral.
Training, Audit and Research
The pain service welcome interested members both medical and non-medical, for observation of clinics and teaching in the management of acute pain and the long term management of chronic pain. Professor Harmon is an adjunct professor of pain sciences in University of Limerick. A comprehensive pain education programme and placement opportunities for medical and nursing trainees is also available supported by Centre for Nursing and Midwifery Education (CNME), Nursing and Midwifery Practice Development Unit (NMPDU) and University of Limerick.
A National E-learning programme ‘Encountering, Assessing and Managing Pain’ was launched in 2013. Pain Consultant Editor: Professor Harmon, Project Manager: Mary McNamara (CNME) in conjunction with clinically based nurses and midwives from around the country. This is the first programme on pain that transcends the multi-disciplinary boundaries, promoting truly inter-professional response to pain through its relevance to nurses, midwives and doctors working in health care in Ireland. The programme can be accessed on www.hseland.ie.