Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
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A NURSING ANALYSIS OF BURN PAIN AND OF THE
MODALITIES FOR ITS RELIEF
Patricia Ann Connor-Ballard Ph.D, APRN-BC
Clinical Nurse Specialist in Adult Health and Assistant Professor of
Nursing
School of Nursing and Health Studies
Georgetown University
3700 Reservoir Road NW,
Washington, District of Columbia, USA 20057
Tel. 202-687-4670
Email pab43@georgetown.edu
Pain following burn injury has been viewed as one of the most
intense pain experiences known to mankind. It is the common
experience of all burn patients regardless of thermal agent, burn
size or depth. Wound care is the primary source of burn pain. The
multi-factorial nature of burn pain makes it difficult to prevent and
manage on a consistent basis. Despite advances in both topical burn
care and pharmacology for sedation and analgesia, the literature
suggests continued inadequacy in assessing, preventing, and
relieving burn pain. Inadequate control of burn pain adversely
affects both patient and nurse. Nursing is at the bedside of the
patient throughout all phases of recovery from burn injury, and
plays a major role in pain assessment and decision-making
regarding pain relief modalities.
To fully describe burn pain, a nursing analysis of burn pain
and of the modalities for its relief was performed using the Wilson
approach for conceptual analysis. Following a brief overview of burn
injury, research literature on burn injury was analyzed to define the
attributes of burn pain: timing and pattern of burn pain, wound care
procedures, burn depth and size, physical and psychological aspects
of burn pain, pain assessment, and available modalities for pain
relief. A concept definition of burn pain is provided, covering both
acute background and procedural pain as well as chronic burn pain.
Three different case studies are presented to illustrate differences in
the burn pain experience across the continuum of recovery from
injury.
Medical advances have resulted in patients now surviving burn
injuries that were considered fatal in the mid-twentieth h century.
Yet pain continues to be a reality following burn injury. Defining
attributes of pain vary per phase of recovery from burn injury. The
analgesic needs of the critically-ill burn patient within hours of
injury differ from those of the ambulatory burn patient requiring
scar revision surgery. Narcotics remain the standard treatment of
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