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OTH 618 Adult Physical Rehab II > Burn Injuries > Flashcards

Burn Injuries Flashcards

1
Q

Which of the following is a common complication of burns involving the hands?
Pressure ulcers
Increased lateral pinch
Deep vein thrombosis
Contractures

A

Contractures

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2
Q

Scar massage with the burn population, has been found to be effective in reducing depression, pruritus and scar height.

A

True

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3
Q

A frostbite is a thermal injury like a burn, and patients with significant frostbite injuries are treated on a burn unit.

A

True

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4
Q

What is the primary purpose of pressure garments in burn rehabilitation?

A.
Improve cosmetic appearance

B.
Enhance joint mobility

C.
Reduce pain sensation

D.
Minimize hypertrophic scarring

A

D.
Minimize hypertrophic scarring

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5
Q

This phase of burn rehabilitation occurs within the 72 hours following the injury and consists of medical management of injuries and stabilizing the patient through mechanical ventilation or cardiopulmonary support.

Rehabilitation

Acute

Emergent

Reconstructive

A

Emergent

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6
Q

According to your reading, when positioning a client with anterior neck burns, each of the following are good options for reducing the potential for a future neck deformity to develop EXCEPT?

Apply a half mattress to extend the neck

Place at least 3 bed pillows under the head to elevate the upper body

Apply a neck collar

Fabricate a neck extension splint

A

Place at least 3 bed pillows under the head to elevate the upper body

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7
Q

This burn thickness consists of blotchy areas mixed with a whitish painful wound due to damage of the blood vessels and dermal layer is known as which of the following?

A.
Full thickness burn

B.
Deep partial thickness burn

C.
Superficial partial thickness burn

D.
Superficial burn

A

B.
Deep partial thickness burn

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8
Q

Which of the following is NOT a factor when calculating the depth of a burn injury?

A.
Age of the patient

B.
Cause of the burn

C.
Depth of the burn

D.
Percentage of body surface area affected

A

A.
Age of the patient

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9
Q

who is the team on a burn unit?

A

OT, PT, nursing, psychiatry / psychiatry, plastic surgeon and or hand surgeon, surgeon for debreadment, internal medicine Dr. , renal doctors, cardiology, pharmacy, pulmonary, nutrition/dietician, Respiratory therapy

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10
Q

What are the protective quality of the skin

A

Protective cover
Regulates body temp
Shields deep structures from injuries
Protects nerve endings

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11
Q

What temp are burn units, why?

A

warm because people with burns have a hard time regulating temp and they need that energy to heal not stay warm.

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12
Q

what layer is the epidermis

A

superficial

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13
Q

what layer is the dermis

A

deep

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14
Q

Types of burns

A

Thermal
Chemical
Electrical
Radiation
Friction

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15
Q

What is a thermal injury

A

heat or cold that impact skin and structures

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16
Q

What are chemical burns

A

when skin is in contact with a chemicals that can burn the skin. splash wounds from not using protective gear

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17
Q

What is an electrical burn

A

home repair, there are usually two wound sites

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18
Q

radiation

A

burns from cancer treatments

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19
Q

friction

A

motorcycle accidents or anytime there is friction that causes the inury. burn unit might consult on that.

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20
Q

superficial frostbite

A

Superficial: damage to skin and underlying subcutaneous tissue

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21
Q

deep frostbite

A

Deep: damage tissue beneath the skin and subcutaneous tissue involving muscle, tendon & bone

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22
Q

superficial thickness (1st degree burn)

A

Damage to epidermis
Epidermis is intact
Red/pink
sunburn
Does not count toward Total body surface area (TBSA %)

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23
Q

superficial burns will feel

A

pain, but no blisters and no scars

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24
Q

Superficial Partial Thickness

A

Damage to epidermis and upper layer of dermis
blistered, painful & raw
Hair follicles intact
Heal within 7-21 days with minimal to no scarring

Will heal on it’s own, it just take time.

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25
Q

Deep Partial Thickness (Deep 2nd degree)

A

Injury to epidermis and severe damage to dermis
Blisters easily removed
Red, beefy, non-blanchable
Hair follicles intact
3-5 weeks healing; often grafted

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26
Q

Full Thickness (3rd degree)

A
  • Both epidermis and dermis are destroyed
  • Damage to subcutaneous fat, muscle & bone tissue
  • Hair follicles damaged
  • Leathery & white, black, brown or yellow
  • No sensation
  • Require surgical care, grafting or amputation
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27
Q

what kind of burns are more likely to be full thickness burns

A

electrical

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28
Q

electrical burns have how many wounds

A
  1. and entrance and an exit, kind of like a gunshot.
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29
Q

What does electrical burns tend to effect

A

everything.

30
Q

what would get someone on the burn unit?

A
  • All with thermal or chemical burns
    > 10% full thickness burn
    > 20% partial thickness burn
  • Any circumferential extremity burn (full or partial thickness)
  • Deep 2nd or 3rd degree of face, hands, feet, & perineum
  • inhalation injury
31
Q

what can hyperbaric chamber help with

A

inhalation injury and burn healing. increases oxygenation of the blood and reduces carbon dioxide.

32
Q

Medical issues related to burns

A
  • Infection
  • Pulmonary complications
  • Metabolic complications
  • Cardiac/circulatory complications
  • Heterotopic Ossification
  • neuropathy
33
Q

burns can convert from one type to another, how?

A

infection. can cause a 2nd degree burn turn into a 3rd degree for example.

34
Q

sepsis can happen from a burn

A

true

35
Q

pulmonary complication may be present in a burn injury

A

true

36
Q

because there is more fluid from swelling with burns what system can be impacted

A

cardiac / circulatory complication

37
Q

what is heterotopic ossification

A

when the body creates more bone structures when there is an injury. Hips are number one location where HO can occur.

38
Q

what the sign of Heterotropic ossification

A

red, swollen joints, trouble bending or moving. typically ortho treats HO. PTs might do range of motion under anesthesia to break up the adhesions.

39
Q

escharatomy

A

procedures while on a burn unit. An escharotomy is an emergency surgical procedure involving incising through areas of burnt skin to release the eschar and its constrictive effects, restore distal circulation, and allow adequate ventilation

40
Q

Typical wound care for burns

A

This is a specialty position. wet to dry dressing. check with nurse to see what the status. OT don’t necessarily do this on burn units the nurses do.

41
Q

exising the wound

A

scalpel to wound under anesthesia

42
Q

hydrotherapy

A

whirlpool water with antibacterial solution

43
Q

Hyperbaric oxygen treatment

A

a set time where the pt goes to the chamber, it helps heal wounds.

44
Q

What is the first choice of graft

A

auto graft - skin from one place in the body placed in another

45
Q

What is Homograft (allograft):

A

cadaver; temporary 7-10 days

46
Q

What is Xenograft (heterograph):

A

pigskin; temporary

47
Q

Bilayer skin substitute:

A

permanent skin substitute

48
Q

Sheet graft:

A

full thickness.A sheet graft is a skin graft that uses a piece of skin from an unburned area of the body to cover a burn wound. The skin is the same size as the wound, and doesn’t stretch.

49
Q

Mesh graft:

A

Mesh grafts are split-thickness or full-thickness skin grafts in which parallel rows of staggered slits have been cut. The mesh incisions allow the graft to be expanded to cover large defects, provide a route for drainage of blood or serum from under the graft, and increase the flexibility of the graft so that it can conform to uneven recipient beds.

50
Q

after skin grafts when can you start moving

A

7-10 days only when surgeon says its ok.

51
Q

If scars are left untreated what can happen

A

hypotrophic scar

52
Q

compression bandage and scar massage used to be the only thing but what is now helping a lot

A

laser treatments

53
Q

Acute phase evaluation

A

Edema
Functional A/PROM
Strength
Sensation
Self-care skills

54
Q

OT intervention in acute phase

A

splint construction for hands, elbow and or neck.

we will assess edema.

55
Q

What do we want to do right away in acute phase (you can even do it when their unconscious)

A

PROM
if they’re awake you have to arrange it will pain meds and it’s AROM and PROM

56
Q

What ADL is important right away

A

feeding

57
Q

How can you adjust things for feeding

A

build up handles on utensils. use curlix?

58
Q

What grooming ADL can you address in acute care?

A

teeth brushing. no bathing

59
Q

Treatment Focus in acute phase for burn patients

A

Prevent loss of jt./skin mobility

Prevent loss of strength & endurance

Control edema

Self-care skills

Education of pt./family

Psychosocial support

60
Q

What are the angles for the optimum position for the wrist and hand to prevent contracture

A

70° flexion at the MP. 30° extension at the wrist. Thumb tucks under with a little bit of space. Wrap with Kerlix

61
Q

Evaluation in surgical post operative phase

A

Functional A/PROM
Dexterity / Coordination
Strength
Self-care
Sensation
Mental status

62
Q

Confusion is one of the first symptoms of

A

sepsis

63
Q

Surgical post op treatment focus

A

Positioning
Splinting
Exercise
Self-care
Cognitive stimulation
Psychosocial adjustment

64
Q

What’s challenging with a facemask

A

eating, ADLs, psychosocial impacts emotions, high level of non-adherence

65
Q

Evaluation phase of post-surgical

A

A/PROM, Stretching
Dexterity/Fine Motor
Strength
Sensation
Coordination
ADL’s (basic and IADLs)

66
Q

Post surgical rehab phase - Evaluation

A

Prevocational assessment
Compression garments
Patient education

67
Q

post surgical rehab phase - Treatment Focus

A

Positioning
Splinting or reworking their splints
Sensory reeducation
Exercise
ADL’s
Work-related skills

68
Q

OT Intervention Outpatient OT or Burn Clinic Follow-up

A

Ongoing reconstructive/plastic surgeries
Exercise
Scar control
Splinting
Positioning
Work-related skills

69
Q

What kind of splint would you use for a burn pt?

A

It’s like a resting hand splint but the angles are different. 70* flexion in mps and 30* extension in wrist (look this up)

70
Q

What do we do for face burns

A

mask, autoform for scars.

71
Q
A

OTH 618 Adult Physical Rehab II (20 decks)

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