Pain Management

Refer to Analgesia and Sedation Management CPG for Prolonged Field Care.

Burns can be painful and can cause hypovolemia. Thus, frequent, smaller doses of an IV opioid or ketamine are preferred.

- In hypovolemic burn patients, ketamine can be used for severe pain or for painful procedures, but less than the full anesthetic dose is safer (e.g., 0.1–0.2mg/kg IV push, assess response and redose ketamine as needed every 5–10 minutes).
- For prolonged care of burn patients, a ketamine infusion may provide more consistent analgesia and help conserve supplies of analgesic medications.
- Burn wound care is extremely painful. Ensure an adequate supply of analgesic agents is available before starting wound cleaning, debridement, escharotomy, or dressing change. Refer to Analgesia and Sedation CPG or obtain telemedicine advice for adequate dosing of procedural analgesia for burn care.
- Consider administering an oral or IV benzodiazepine for anxiety (common with repeated painful wound care).