Burn pain management: a guideline-based approach

The pain associated with burn injury and treatment often is managed poorly. The purpose of this article is to describe available pain-management guidelines and to explain how burn pain can be enhanced by using a guideline-based approach. Data from a retrospective audit are used to highlight several of the common causes of pain mismanagement: including inadequate pain assessment, analgesic-knowledge deficits, and incomplete documentation. Key recommendations from the Agency for Health Care Policy and Research's Acute Pain Management Guidelines are highlighted. Guideline-based suggestions from these and other guidelines are presented as a basis for burn pain management-guideline development. Guidelines for burn-pain management must be broad in scope to allow for variations in analgesic needs across all patient populations and phases of burn recovery. Guidelines are necessary because studies show that information and education alone have little effect on the quality of pain management. What is effective are guideline-based initiatives that make pain visible and care providers accountable.