000			03122nam a22002177a 4500
003			OSt
005			20240305193658.0
008			230316b |||||||| |||| 00| 0 eng d
040			_cDLC
041			_aEnglish
100			_aVihar Rajendra Kotecha _948486
245			_aAdequacy of Acute Pain Management in Adult Patients Admitted With Thermal Burns at Kenyatta National Hospital
260			_aNairobi, Kenya _bUniversity of Nairobi _c2016
300			_a66 Pages
300			_aIncludes References and Appendices
520			_aAbstract: Background: Worldwide incidence of adult thermal burns is 3-10%. Thermal burns cause significant tissue injury leading to acute pain which if not adequately controlled leads to delayed wound healing, prolonged hospital stay and psychological disturbances like depression and posttraumatic stress disorder. There is paucity of literature concerning burn pain assessment and adequacy of its control in our setup. This study aimed to assess the adequacy of pain control in adult patients with thermal burns admitted to KNH. Methods: A descriptive study with a sample size of 138 adult patients admitted to KNH due to thermal burns were recruited for this study. Study duration was six months from February to July 2015. The data collected was demographic data, aetiology of burns, pain scores using Visual Analogue Scale, degree of burn and mode and type of analgesics offered. Data was analysed using STATA v.11.2, frequencies, means, medians were used to describe data. Student’s t- test & chi-square were used to test for statistical significance with p-value of < 0.05 showing statistical association. Results: Median age of the study population was 28 (IQR 22-38), majority were males 65%. Sixty- five percent sustained moderate to major burns. Etiologies were mainly flame and scald each contributing 35% respectively. Pain assessment was not done in majority at A&E and wards 98% & 95% respectively. The correlation between TBSA and intensity of pain and degree of burn and intensity of pain was not statistically significant. Pain control at KNH was found to be inadequate with only 17% having adequate background control of pain and 7% having adequate procedural pain control. There was judicious use of analgesics at A&E (96%) but this not a common practice during change of dressing (29%). Mostly the mode of offering analgesia was unimodal 77% at A&E and during dressing. The choice of analgesics was opioids in both places. Conclusion: Pain assessment is not a common practice at KNH hence its management was very arbitrary. Pain control is inadequate amongst patients with thermal burns at KNH. These findings are contrary to the recommendation from other burn centres. Judicious use of analgesics is recommended to control procedural pain, but at KNH only 26% of the patients received analgesics during change of dressing yet the VAS scores remained at moderate pain to severe pain despite the use of procedural analgesics
600			_xSurgery _929082
700			_aOpot Elly Nyaim _948487
700			_aNang’ole Ferdinand Wanjala _948488
942			_2ddc _cMP
999			_c18737 _d18737