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Analgesia protocols for burns dressings: Challenges with implementation
S L Wall1, D L Clarke1, N L Allorto1
1Pietermaritzburg Burn Service Pietermaritzburg Metropolitan Department of Surgery, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa.
Summary
Doctors in peripheral hospitals show significant gaps in pediatric burn pain management knowledge compared to those in academic centers. This highlights a need for standardized training and reinforced protocols to improve patient care quality across all facilities.
Area of Science:
- Medical Education
- Pain Management
- Pediatric Burn Care
Background:
- Analgesia protocols for pediatric burn patients exist but vary in reinforcement.
- A disparity in knowledge regarding pain management for children with burns was investigated.
Purpose of the Study:
- To compare doctors' knowledge of analgesia in pediatric burn patients.
- To assess the impact of protocol reinforcement on pain management practices.
Main Methods:
- Anonymous questionnaires were distributed to doctors managing pediatric burn patients.
- Data was collected from doctors in an academic hospital and peripheral referral hospitals.
Main Results:
- Doctors in the academic center demonstrated superior knowledge of ketamine dosing for procedural sedation compared to referral hospital doctors (80% vs. 8%).
- Significant differences were observed in the choice of procedural sedation agents (ketamine use: 100% vs. 39%) and assessment methods for pain adequacy.
- Referral doctors were less likely to use standardized scoring systems, with some relying on indicators like a child screaming.
Conclusions:
- A significant knowledge gap exists between academic burn centers and peripheral referral hospitals regarding pediatric burn analgesia.
- This discrepancy directly impacts the quality of pain management received by pediatric burn patients.
- Standardizing care and reinforcing protocols across all institutions are crucial for improving outcomes.
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