Topic Five: Pain Management

Management of pain in patients with burn injuries can often be inadequate, underestimated and undertreated. All patients ideally should have individual pain management plans based on a full assessment. Pain should be based on the patient’s individualised pain scores.

Superficial burns injuries can be extremely painful, and exacerbated through procedures such as cleansing, debridement, application of gels/creams and dressing changes. Complex/ deeper burns may initially present with minimal pain due to the damage done. However, pain increases as the injury starts to heal.

Analgesia should be provided in advance of any interventions to be performed and delayed ensuring the analgesia has its full effect. Involving, where able the patient and asking their pain levels at dressing changes can improve their experience and concordance. There are a variety of pain scales that can be used. (See Module 3 section 1).

Employment of these scales can inform of the type of pain, the pain relief selected and reduce anxiety and negative associations with wound care. The significance of a friendly conversation and distraction techniques should not be underrated, and where feasible, participation in dressing change can be encouraged.

(International Best Practice Guidelines, 2014; Jeschke et al., 2018)