Pain Assessment and Treatment for the Trauma and Burn Patient

The pain associated with burn and trauma is one of the most common causes of distress during the first year of recovery after injury. Trauma is often associated with high-intensity acute pain. It can be prolonged and debilitating. A burn injury is one of the most severe forms of trauma that a person may experience. The pathophysiology of burn pain is not well understood. There are limited clinical trials to assess the effectiveness of analgesia in trauma and burn patients. Acute pain management of burn pain consists of treating background pain, breakthrough pain, and procedural pain. Effective treatment of each of these types of pain requires frequent review and assessment by trained healthcare providers and the incorporation of multimodal analgesia along with the addition of carefully titrated analgesia for breakthrough pain. Inadequate pain control after trauma and burns has been associated with poor quality of life, psychological distress (PTSD, anxiety, depression), delayed return to work, worse medical outcomes, and the development of chronic pain syndrome. Early pain treatment is assumed to effectively reduce pain in patients and improve long-term outcomes. In order to provide optimum pain management care to the trauma and burn patient, it is imperative that practitioners are educated in modern evidence-based practices and standardized protocols. Multidisciplinary pain strategies for the treatment of trauma and burn pain patients typically include physical therapy, psychological care, and pharmacologic management. The ultimate goals for pain management in the trauma and burn patient are to reduce mortality and morbidity, shorten length of hospital stay, contribute to early mobilization (via participation in physical therapy), reduce hospital costs, lower the amount of long-term opioid prescribing, and enhance patient’s satisfaction and quality of life.