Pain in the patient with burns

Norman, Aidan T; Judkins, K.C.

doi:10.1093/bjaceaccp/mkh016

Cited by 33 publications

(35 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…67 Once these have been managed, the burn injury should be assessed through percentage of total body surface area, degree of burn injury, and patient characteristics (age, comorbidities). This assessment allows for some prediction of the pain intensity.…”

Section: Clinical Practicementioning

confidence: 99%

“…Analgesia can then be initiated based on this predicted pain level. 67 Another method of treatment consists of following the analgesia ladder: step 1, nonopioids (acetaminophen, NSAIDs); step 2, mild opioids (codeine); step 3, strong opioids (morphine). 15,68 In acute mild burn pain, patients should be prescribed acetaminophen regularly if they do not have contraindications to this medication.…”

Section: Clinical Practicementioning

confidence: 99%

“…68 NSAIDs should be added to acetaminophen, but should be prescribed with caution in the patient with shock or in the elderly. 67 For moderate to severe acute burn pain, opioid can be administered as adjuncts to acetaminophen and NSAIDs. Laxatives, antiemetics, and opiate antagonists (eg, naloxone) should concurrently be prescribed to prevent and control opioid related side effects.…”

Section: Clinical Practicementioning

confidence: 99%

“…68 Several routes of opioid administration have been suggested to control background pain: orally (short-acting agents: oxycodone, hydromorphone, codeine; long-acting agents: sustained-release morphine or hydromorphone, sustained-release oxycodone, methadone), transdermally, intramuscularly, through a patient-controlled analgesia device, and intravenously (bolus or continuous infusion of morphine or fentanyl). 15,67,69 Breakthrough pain must also be addressed at admission. Opioids should be prescribed as required to control this type of pain.…”

Section: Clinical Practicementioning

confidence: 99%

See 3 more Smart Citations

Pain and the Thermally Injured Patient—A Review of Current Therapies

Retrouvey

Shahrokhi

2015

Journal of Burn Care & Research

View full text Add to dashboard Cite

Thermally injured patients experience tremendous pain from the moment of injury to months or years after their discharge from the hospital. Pain is therefore a critical component of proper management of burns. Although the importance of pain is well recognized, it is often undertreated. Acute uncontrolled pain has been shown to increase the incidence of mental health disorders and increase the incidence of suicide after discharge. Long-term poor pain control leads to an increase in the incidence of persistent pain. Most burn centers have used opioids as the mainstay analgesic, but recently, the significant side effects of opioids have led to the implementation of new and combined therapeutics. Pharmacological agents such as gabapentin, clonidine, dexmedetomidine, and ketamine have all been suggested as adjuncts to opioids in the treatment of burn pain. Nonpharmacological therapies such as hypnosis, virtual reality devices, and behavioral therapy are also essential adjuncts to current medications. This review aims at identifying the currently available pharmacological and nonpharmacological options for optimal pain management in the adult burn population.

show abstract

Section: Clinical Practicementioning

confidence: 99%

Section: Clinical Practicementioning

confidence: 99%

Section: Clinical Practicementioning

confidence: 99%

Section: Clinical Practicementioning

confidence: 99%

See 2 more Smart Citations

Pain and the Thermally Injured Patient—A Review of Current Therapies

Retrouvey

Shahrokhi

2015

Journal of Burn Care & Research

View full text Add to dashboard Cite

show abstract

“…[1][2][3][4][5] When properly performed, regional nerve blocks have an improved safety profile, and decrease the need for nursing and monitoring when compared to procedural sedation. [6,7] However, these procedures are not without complications and still require proper technique and sterile precautions.…”

Section: Introductionmentioning

confidence: 99%

Procedural simulation: medical student preference and value of three task trainers for ultrasound guided regional anesthesia

Lahham¹,

Smith²,

Baker³

et al. 2017

World Journal of Emergency Medicine

View full text Add to dashboard Cite

BACKGROUND: Ultrasound guided regional anesthesia is widely taught using task trainer models. Commercially available models are often used; however, they can be cost prohibitive. Therefore, alternative "homemade" models with similar fidelity are often used. We hypothesize that professional task trainers will be preferred over homemade models. The purpose of this study is to determine realism, durability and cleanliness of three different task trainers for ultrasound guided nerve blocks. METHODS:This was a prospective observational study using a convenience sample of medical student participants in an ultrasound guided nerve block training session on January 24th, 2015. Participants were asked to perform simulated nerve blocks on three different task trainers including, 1 commercial and 2 homemade. A questionnaire was then given to all participants to rate their experiences both with and without the knowledge on the cost of the simulator device.RESULTS: Data was collected from 25 participants. The Blue Phantom model was found to have the highest fi delity. Initially, 10 (40%) of the participants preferred the Blue Phantom model, while 10 (40%) preferred the homemade gelatin model and 5 (20%) preferred the homemade tofu model. After cost awareness, the majority, 18 (72%) preferred the gelatin model. CONCLUSION:The Blue Phantom model was thought to have the highest fidelity, but after cost consideration the homemade gelatin model was preferred.

show abstract