Pain management: Pain caused by burns
Pain management for burns can be difficult, since burns differ in type and severity. There are three types of burns:
- First-degree burns are considered mild compared with other burns. They result in pain and reddening of the epidermis (outer layer of the skin).
- Second-degree burns affect the epidermis and the dermis (lower layer of skin). They cause pain, redness, swelling and blistering.
- Third-degree burns go through the dermis and affect deeper tissues. They result in white or blackened, charred skin that may be numbed.
What causes burns?
Dry heat (such as fire), wet heat (such as steam or hot liquids), radiation, friction, heated objects, the sun, electricity or chemicals can all cause burns. Thermal burns are the most common kind of burns. These occur when flames, hot metals, scalding liquids or steam come into contact with skin. Typical circumstances include house fires, vehicle accidents, kitchen accidents and electrical malfunctions.
What are the symptoms of burns?
- Pain: the degree of pain is not related to the severity of the burn, as the most serious burns can be painless
- Peeling skin
- Red skin
- Shock: symptoms include pale and clammy skin, weakness, bluish lips and fingernails, and reduced alertness
- White or charred skin
Treatment of burns
Burn treatment depends on the type of burn. First-degree burns may be treated by running the burned area under cool running water, covering it with cling film, and using pain medication such as paracetamol or ibuprofen.
Second-degree burns may be treated with an antibiotic cream or with other creams or ointments prescribed by a doctor.
The treatment of third-degree burns may require skin grafting or the use of synthetic skin. Severe burns covering large parts of the body may need more intensive treatments such as intravenous (IV) antibiotics to prevent infection or IV fluids to replace fluids lost when the skin was burned.
Managing burn pain
Burn pain can be one of the most intense and prolonged types of pain. Burn pain is difficult to control because of its unique characteristics, its changing patterns and its various components.
In addition, there is pain involved in the treatment of burns, as the wounds must be cleansed and the dressings changed. Studies show that the management of burn pain can be inadequate, requiring more intensive treatment for pain.