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Resident
Orientation Manual (Feb. 2000)
Produced by Galveston Shriners Burns 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, Janet A
Marvin RN, MSN,
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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