Reaching consensus on an analgesia protocol for paediatric burn patients in a resource-scarce South African community

Abstract

Background: Despite the exceptional burden of burns in low- and middle-income countries (LMIC) and the importance of adequate analgesia in  burn care, there is a lack of analgesia protocol developed in resource-scarce settings. This necessitates the development of an analgesia protocol  applicable to the resource-scarce setting. This study presents the findings of a modified Delphi study aimed at achieving consensus by a panel of  experts in the management of burn injuries from low- and middle-income settings across Africa.

Methods: A two-round Delphi survey was conducted to achieve consensus on an analgesia protocol for paediatric burn patients for a resource-  limited setting. The Delphi panel consisted of nine experts with experience in management of burn injuries in low-income settings.

Results: Consensus was determined by an a priori threshold of 80% of agreement for a drug to be included in the analgesia protocol. There was a  largely overarching agreement with regard to the background analgesia protocol and strong agreement regarding the use of an initial dose of  ketamine and midazolam for procedural sedation.

Conclusion: A modified Delphi method was used to obtain expert consensus for a recently adopted analgesia protocol for burn-injured children in a  resource-limited setting, with experts in the management of burn injuries in low- and middle-income settings. The expert consensus leads to the  rigour and robustness of the protocol. Delphi methods are exceptionally valuable in healthcare research and the aim of such studies is to find  converging expert opinions.