When a patient reaches medical care, one of the first instincts for both the patient and the care giver is to address the pain level of the patient and to immediately attempt to relieve the pain. However, Wiebelhaus and Hansen (2001) explain that, with burn patients, pain assessment must come secondary to assessing the extent of the burns and any other potential life-threatening issues. The airways must be cleared and the patient should be assessed for carbon monoxide poisoning. Following this primary assessment, the patient must begin to receive fluids and then the pain management can be addressed. Askay, Patterson, Sharar, Mason, and Faber (2009) explain that “management of acute and chronic pain involves multiple modalities, including long and short-acting opiates, anxiolytics, and non-pharmacological technique” (pg. 522). Wiebelhaus and Hansen (2001) note that the primary method of immediate pain relief for burn patients is morphine that is given along with the IV fluid restoration therapy. However, the authors also explain that the location of the IV may vary based on the severity and location of the burns. Additionally, if there is a known allergy to morphine or any of its components, fentanyl is the secondary option for immediate pain relief (Wiebelhaus & Hansen, 2001).
Noting that the pain will manifest in multiple contexts to include background pain, procedural pain, breakthrough pain, and postoperative pain, Askay, Patterson, Sharar, Mason, and Faber (2009) explain that multiple types of pain management will be necessary at these various stages. The authors state that, beyond opiates and IV interventions, oral nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen can also be used to manage the pain for burn victims. Topical creams as well as psychological pain management therapies are also indicated as being helpful methods to manage the various stages of pain for burn patients over the healing processes and procedures.
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