Reaching consensus on an analgesia protocol for paediatric burn patients in a resource-scarce South African community

Abstract

Background: Despite the exceptional burden of burns in low- and middle-income countries (LMIC) and the importance of adequate analgesia in burn care, there is a lack of analgesia protocol developed in resource-scarce settings. This necessitates the development of an analgesia protocol applicable to the resource-scarce setting. This study presents the findings of a modified Delphi study aimed at achieving consensus by a panel of experts in the management of burn injuries from low- and middle-income settings across Africa.Methods: A two-round Delphi survey was conducted to achieve consensus on an analgesia protocol for paediatric burn patients for a resource-limited setting. The Delphi panel consisted of nine experts with experience in management of burn injuries in low-income settings.Results: Consensus was determined by an a priori threshold of 80% of agreement for a drug to be included in the analgesia protocol. There was a largely overarching agreement with regard to the background analgesia protocol and strong agreement regarding the use of an initial dose of ketamine and midazolam for procedural sedation.Conclusion: A modified Delphi method was used to obtain expert consensus for a recently adopted analgesia protocol for burn-injured children in a resource-limited setting, with experts in the management of burn injuries in low- and middle-income settings. The expert consensus leads to the rigour and robustness of the protocol. Delphi methods are exceptionally valuable in healthcare research and the aim of such studies is to find converging expert opinions.

An Introduction to Burn Care: The Sequel

“…General burn wound management also includes ensuring an up-to-date tetanus immunization status and early prevention and treatment of pain and anxiety. 16 Burn size needs to be measured quickly. In combination with preexisting comorbidities and/or burn accidentrelated complications such as an inhalation injury or The patient provided permission for this image to be published.…”

“…After cooling and neutralizing or inactivating chemicals, clean partial-thickness (PT) and full-thickness (FT) burns with soap and water or nonirritating skin disinfectants, and perform superficial debridement to remove devitalized and necrotic tissue or epithelium. General burn wound management also includes ensuring an up-to-date tetanus immunization status and early prevention and treatment of pain and anxiety 16 …”

Tratamento Da Dor Em Pacientes Vítimas De Queimaduras Agudas

“…Pode-se considerar uma ferramenta complementar útil a terapia farmacológica e ao mesmo tempo de fácil acesso. Autores 32,33 consideram que ABSTRACT -Pain in patients suffering from acute burns can vary and the techniques described can achieve optimal management, improving recovery results and avoiding long-term psychological sequelae. The present study aimed to establish currently the best methods of treatment for pain in acute burn victims.…”