Ok, this happened on Law and Order SVU so I realize it may not be based in reality.
Basically, a woman was really badly burned - 2nd and 3rd degree burns on most of her body. They needed to debried the wounds and were going to use a water sprayer - the Dr. (actor) said she would probably die of shock from the procedure. The two detectives leave and you can hear her screaming from the procedure.
So - here’s the question - wouldn’t they give her a sedative, or put her into a chemically induced coma or some shit? Surely if she’s probably going to die anyway, doping her up wouldn’t hurt anything.
Weird. On both CSI and House there were episodes involving severely burnt patients. On both shows the patients were either put into comas or really sedated.
Maybe Law & Order just didn’t have time to write that in to the plot?
Not a burn, but I had the flesh torn away on a fairly large portion of my leg. I was first taken to a civilian hospital and signed myself out after a couple of days. A few days later I had the bandaged changed by the civilian doc. who had treated me, he debrided the wound and I’m pretty sure he used some local anesthetic. He tried to get me back in the hospital, but I blew it off. A couple more days and the leg was hurting like hell, so I called the civilian doc. who had treated me. He met me at the local hospital and debrided again, this time w/ no anesthetic, I didn’t scream, but it hurt like hell. The doc. told me that he would not treat me again, that I must go into the hosp. A couple of days later I checked into an Air Force hospital. Eventually they did a skin graft to cover the wound. The injury was too deep for the skin to regenerate.
Sometime later I worked in a large hospital and my job sometimes took me to their burn unit. Some of the patients there were in pretty bad shape.
The hospital had a well respected staff in the burn unit and they often got the worst cases in the area. I recall that they were doing grafts w/ pig skin, which I think was pretty new, this was 1980.
I worked with a man who had fallen into an acid tank several years before. He said at first he tried not to scream, but the burn therapy nurses told him it was healthier to scream when they peeled off the dead tissue. The doctors told him that doping him up would slow down the healing. He developed a different attitude about pain.
That’s some scary shit. By the way, if he had forsaken modesty and stripped down under the emergency shower, his burns would not have been so severe. Remember that. Sometimes being naked can save your life.
So - is the answer that it depends on the hospital, or (as I sort of suspect) the whole “feel the pain” thing is a bit of an old school idea? I know that most current pain specialists suggest that NOT feeling pain, even if it means being dopey, speeds healing - perhaps this doesn’t apply to burns?!?
Often severe burn pts have injury to their airway, if you gasp or such while in the fire this can lead to major swelling, so we always intubate a pt if there’s a risk of airway involvement. We do that in the er even if they’re not in respiratory trouble yet; it’s better to get the tube in before the swelling, cuz you might not be able to get it in after. This always involves major sedation unless the pts already in a coma, then we don’t use as much but will still give some. Of course, sedation isn’t analgesia, I’ve never been involved with a burn pt when we didn’t give as much morphine as it took.