Keterangan
The majority of small burns can be effectively treated in an outpatient setting and recover with no need for intervention. A precise classification of burns is essential to ensuring appropriate care. Thermal burns are injuries to the skin brought on by extreme heat, usually from coming into touch with hot objects, liquids, steam, or flames. The majority of burns are not severe, and patients can receive care at nearby hospitals or as outpatients. Specialized burn centers treat about 6.5 percent of all burn cases. The amount of burned body surface area, the degree of the burns, and the unique characteristics of each patient—such as age, previous injuries, or other medical issues—are taken into consideration when deciding whether to transfer and treat a patient at a burn center.
Ringkasan
- Chronic pain, defined as pain lasting over three months, is an under-recognized problem affecting a significant portion of the population, with incidences ranging from one in five adults in the US to 30% in India. Pain is a subjective experience influenced by biological, psychological, and social factors, and a patient's report of pain should always be respected and addressed. While acute pain serves an adaptive role in preventing further injury, chronic pain no longer serves a productive purpose and significantly interferes with quality of life.
- Chronic pain often leads to a pain cycle involving muscle guarding, spasm, inflammation, restricted movement, weakness, and psychological issues like anger and frustration. Breaking this cycle requires a multimodal approach, including medication, injections, and multidisciplinary treatment to improve functionality and enhance the patient's quality of life. Assessment involves history taking, clinical examination, investigations, and diagnostic interventions like nerve blocks.
- History taking is critical, emphasizing the need to rule out "red flags" indicative of serious underlying conditions. Key elements include the site, quantity, quality, onset, duration, aggravating and relieving factors, special characteristics, timing, relation to posture, and associated complaints. Pain is often considered the fifth vital sign, measured using tools like the numerical rating scale (NRS), faces pain rating scale, and visual analogue scale (VAS).
- Common chronic pain conditions include tension headaches, migraines, cluster headaches, and trigeminal neuralgia, a facial pain condition often treated with carbamazepine and nerve blocks. Chronic neck pain can arise from various sources, including muscles, facet joints, intervertebral discs, and nerves. "Text neck," caused by prolonged phone use, can contribute to neck pain and other health problems. Low back pain can stem from herniated lumbar discs, facetogenic pain, and sacroiliac joint dysfunction, often requiring MRI imaging and nerve root blocks or radiofrequency ablation.
- Neuropathic pain presents with symptoms like burning, tingling, electric shocks, and crawling sensations. Post-herpetic neuralgia, a common neuropathic condition following herpes zoster, can be managed with anti-neuropathic medications and nerve blocks. Musculoskeletal pain and joint pains, like osteoarthritis of the knee, can be addressed with regenerative pain medicine techniques like platelet-rich plasma (PRP) therapy or genicular nerve blocks. Myofascial pain, caused by trigger points in muscles, is often underdiagnosed and can be treated with local anesthetic injections.
- Fibromyalgia is a diagnosis of exclusion, characterized by widespread musculoskeletal pain, fatigue, and cognitive/psychiatric disturbances, requiring lifestyle changes and anti-neuropathic medication. Chronic cancer pain can be managed using the WHO pain ladder, involving non-opioid analgesics, weak opioids, and strong opioids like morphine and fentanyl, alongside nerve blocks like celiac plexus block for upper abdominal malignancies. The management of chronic pain generally requires a multidisciplinary approach that integrates medications, procedures, physical therapy, lifestyle adjustments, psychological support, and specialist coordination.
Contoh Sertifikat
Tentang Pembicara
Dr. Saipriya Tewari
Consultant Pain Medicine and Palliative Care, Manipal Hospital, New Delhi
Pengungkapan Keuangan
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