Medical workers' cognition of using 50% nitrous oxide in children with burns: a qualitative study
Hai-Xia Wang1, Yu-Xiang Li2, Ru-Zhen Zhou3
1Department of Burn ICU, Changhai Hospital, Second Military Medical University, Shanghai, China.
Insights
Pediatric burn pain management during wound dressing is suboptimal. Healthcare workers support using 50% nitrous oxide (N2O) for children with burns, advocating for updated guidelines and administrative support.
Area of Science:
- Pediatric Burn Care
- Pain Management
- Anesthesiology
Background:
- Pain during wound dressing is a significant issue for children with burns.
- Effective pain management is crucial for reducing anxiety and psychological distress in pediatric burn patients.
Purpose of the Study:
- To investigate healthcare workers' understanding of current pain management practices for children with burns during dressing changes.
- To assess healthcare workers' attitudes towards using 50% nitrous oxide (N2O) for pain management in this population.
Main Methods:
- Qualitative descriptive study involving in-depth interviews with seven doctors and nurses at a burn center in East China.
- Data analysis through full transcription and thematic identification.
Main Results:
- Healthcare workers expressed sympathy for pediatric burn patients and identified a gap in current pain management, with a preference against routine analgesic prescriptions.
- Following exposure to literature, medical staff showed a tendency to consider 50% N2O for pediatric burn patients, mirroring its use in adults.
- Current guidelines for 50% N2O application in children require refinement; pain management was deemed unsatisfactory, yet 50% N2O was supported.
Conclusions:
- Pediatric burn pain management during dressing changes is perceived as unsatisfactory by healthcare professionals.
- There is support among medical staff for the application of 50% N2O in pediatric burn patients, contingent on guideline development and administrative approval.
Abstract:
Pain caused by dressing among children with burns is an issue worth discussing. Medical workers' understanding of pain during dressing in children with burns is correlated with the quality of pain management. Effective pain management is significant to improve anxiety and reduce pain and psychological distress during dressing for children with burns. We aimed to investigate medical workers' understanding of current pain management during dressing among children with burns and their attitudes toward the application of 50% nitrous oxide in pain management. Interviews were conducted with seven doctors and nurses from a burn center in East China. Data were collected by in-depth interviews and qualitative description after full transcription of each interview. Three themes were identified: (1) Medical workers felt sympathy for children with burns and believed that a gap existed between the current and expected situation in pain management. In addition, the prescription of analgesics during dressing for children with burns was not favored. (2) Given the fact that 50% nitrous oxide is effective in pain management for adult patients with burns, medical workers tended to apply it to children with burns during dressing after being provided the literature on the use of 50% nitrous oxide in children. (3) Guidelines for the application of 50% nitrous oxide during dressing for children with burns require further modification. Medical workers deemed the pain management for children with burns unsatisfactory, and they supported the application of 50% nitrous oxide during dressing for children with burns. Meanwhile, they hoped that administrators would also support it.
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