Table 5.

Sedation and Analgesia Guidelines for Acute Burns

Stage of Injury	Background Anxiety	Background Pain	Procedural Anxiety	Procedural Pain
Acute Burn Ventilated	#1 Midazolam infusion	Morphine infusion	Midazolam boluses	Morphine boluses
	#2 Dexmedetomidine infusion	Morphine infusion	Dexmedetomidine higher infusion rate	Morphine boluses
	#3 Antipsychotics	Morphine infusion	Haloperidol (very slow) boluses	Morphine boluses
	#4 Propofol infusion (<48 h)	Morphine infusion	Propofol boluses	Morphine boluses
Acute Burn not ventilated	Dexmedetomidine IV Scheduled Lorazepam IV or PO	Morphine IV or PO	Lorazepam IV/PO	Morphine IV/PO or Ketamine IV
Chronic Acute Burn	Scheduled lorazepam or antipsychotics (PO)	Scheduled morphine or methadone	Lorazepam or antipsychotics (PO)	Morphine PO or Oxycodone

Fentanyl infusions could be substituted for morphine infusions.

In view of the increased incidence of delirium with benzodiazepines, minimal use of them is advocated.

IV = intravenous. PO = per oram (by mouth).