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Resident Orientation Manual

Produced by Galveston Shriners Burn Hospital and
The University of Texas Medical Branch Blocker Burn Unit.
Contributors:  Sally Abston MD, Patricia Blakeney PhD, Manubhai Desai MD,
Patricia Edgar RN, CIC,John P Heggers PhD, David N Herndon MD,
Marsha Hildreth RD, Ray J Nichols Jr. MD

 

MANAGEMENT OF ITCH DUE TO INFLAMMATORY RESPONSE IN BURN SCAR AREA

1)  Use moisturizing body shampoo and lotions to alleviate itching due to dry, scaly skin.

2)  Topicals:
a.  Preparation H: Astringent properties relieve itch.
b.  Benadryl Cream: Sometimes helpful in relieving itch.
c.  Hydrocortisone 1% Cream: Low potency corticosteroid.  Used only in very resistant cases because of corticosteroid necrotizing local effect.
- Need Attending Staff approval -

3)  Diphenhydramine (Benadryl):
a.  Sedating properties useful in calming patient, thus relieving itch.
b.  Antihistamine properties useful in management of itch due to morphine histamine release.
c.  May cause hyperactive paradoxical effect.
d.  Dose:  1.25 mg/kg/dose PO q6h.

4)  Hydroxyzine (Atarax):
a.  Literature states hydroxyzine most effective antihistamine for chronic urticaria.
b.  Dose:  0.5 mg/kg/dose PO q6h.

5)  Cyproheptadine (Periactin):
a.  Phenothiazine side effects useful in producing sedation and itch management at bedtime.
b.  Dose:  0.1 mg/kg/dose PO q6h.

6)  Loratidine (Claritin):
a.  Non-sedating antihistamine.
b.  Dose:  Children > 6 years of age = 10mg.

 

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