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618 Phys Dys 2 Quiz1 > Burn Management > Flashcards

Burn Management Flashcards

1
Q

High Risk Populations

A 
Elderly 
Young children 
Physically disabled 
Mentally ill 
Workers in hazardous conditions
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2
Q

Skin Functions

A

Protective cover
regulates body temp
shields deep structures from injuries
protects nerve endings

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3
Q

Skin Anatomy : Epidermus

A

Regenerates

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4
Q

Skin Anatomy: Dermis

A

Nerve Damage and Sensory loss occurs

Does not regenerate: requires graphing

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5
Q

Classification of Burns is determined by

A

Type of burn
Depth of burn
TBSA= total body surface are involved in burn

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6
Q

Thermal Burn

A

Flames, steam, metal, frost bite

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7
Q

Chemical Burn

A

Acids: Usually work/industrial

Splash burns

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8
Q

Electrical Burn

A

Currents (usually the worst type of burns)

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9
Q

Radiation Burn

A

Sun burn, cancer survivors

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10
Q

Friction Burn

A

Vehical accidents: impact w/ gravel

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11
Q

Burn Depth: Superfical Partial Thickness

A

Damage to the epidermis and upper layer of dermis
Intact blisters and pain (pain indicates nerve endings are intact)
Heal w/in 7-21 days w/ minimal to no scaring

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12
Q

Burn Depth: Deep Partial Thickness

A

Injury to epidermis and severe damage to dermis
Blotchy & whitish
+ pressure sense
- light touch
3-5 weeks healing; often grafted
Once skin is grafted & haled sensory return is very limited

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13
Q

Burn Depth: Full Thickness

A

Usually smaller patches of area
Both epidermis and dermis are destroyed
May damage subcutaneous fat, muscle & bone tissue
Wounds are white and waxy
- sensation d/t destruction of dermal nerve endings
Require surgical care grafting or amputation

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14
Q

Medical Issues Related to Burns

A

Infection
Pulmonary complications (CO2 intake: house fires)
Metabolic COmplications: burns result in an increased need for calories: pts. have rapid weight loss: calories (protein) help promote healing and regulate body temp.
Cardiac/Circulatory complications: large demands are placed on vital organs. Pt. has increased swelling & fluid build up.
Heterotophic Ossification: pt. lay done tissue on tendons (sensative to ROM)
Neuropathy

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15
Q

Medical Management : Escharotomy

A

Surgical procedure done to circumfuernatal burns to releave compression. They make an incision to provide space for fluid to build up

Addition medical management: wound care

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16
Q

Medical Management: Septic Shock

A

Toxins are released into the body: bactira is in the blood stream resulting into a drastic drop in BP, increased confusion & agitation, increase in temp.

17
Q

Medical Management: Excision

A

Removal of dead tissue

18
Q

Drugs

A

Narcotics: morphine: used to calm & quiet pt. also avoid the pt. from using their caloric intake.
Analgesics: tylenol: inflimation
Antacids: stress ulcers
Antibiotics: Oral & topical: ant itch medication

19
Q

Graft Types: Autograft

A

From pt; permanent

20
Q

Graft Types: Homograft (allograft)

A

Skin donor; temporary (stapled)

21
Q

Graft Types: Xenograft (heterograft)

A

Pigskin; temporary

22
Q

Graft Types: Bilayer skin substitiute

A

Permanent skin substitute

23
Q

Graft Type: Sheet Graft

A 
Full Thickness 
Scar massage (passive & active) 
Focus on mobility & ROM on dorsal side to avoid claw deformity
24
Q

Graft type: Mesh graft

A

Perforated to increase surface area

25
Q

Key to healing grafts

A

Do not move any area that is freshly grafted.

They should be imobolized (7-10) days

26
Q

Hypertrophic Scars

A

Increase in the following: vacularity, fibroblasts, myofibroblast, interstitial fluid, collagen

Jobst Garments (compression garments) used to prevent scaring. Prevent webbing (i.e. axilla, neck, flexion contractors, elbow, knees)

Issues w/ Jobst: compliance: provide the pt. w/ peer support & before & after pictures

27
Q

Burn Eval: acute Phase

A 
Edema 
Functional A/PROM (pumping)
Strength (bed mobility)
Sensation: pressure, localization 
Self care skills: low level A w/ dressing, glicerin swabs, urinal use
28
Q

Burn Tx : Acute Phase

A

Prevent loss of jt./ skin mobility
Prevent loss of strength/endurance
Control edema (positioning vs manual manipulation)
Self-care skills
Education of pt./family - ON EVERYTHING (Jobst, splinting) education should be repeated frequently
Psychosocial support (body image)

29
Q

Burn Splint : PAN Splint

A

Not a resting hand splint
Prevents claw deformity
Applyed w/ curlex wrapping vs straps
Wrist: flexion, MP: Flexion, IP: Extension

Boutiner deformities also occur along w/ extensor tendon ruptures

30
Q

Hand ROM

A

Wrist flexion = finger extnesion and vice versa

Prevents stress on joints

31
Q

Post Surgical - Operative Phase : Eval

A

Functional A/PROM (goniometry, keep exact records of ROM)
Strength: Dyno/Pinch, 9 hole peg (very standardized)
Self care: address the need for adaptive equipment (large handled devices, button hooks)
Sensation: dependent on wounds: 2point descrimination, localization (look at safety)
Mental status: coping and depression
Motivation

32
Q

Post Surgical - Operative Phase : Tx

A

Positioning
Splinting: moves from static to dynamic
Exercises: increase strength, fine & gross motor exercises, adapt as they heal
Self-care : increased refinment & adaptive strategies
Cognitive stim: (d/t smoke inhalation) adaptive strategies
Psychosocial adjustment

33
Q

Rehab Phase : Eval

A 
Increased persions 
A/PRROM (still standardized) 
Strength
Sensation: sems winstein
Coordination: build of 9 hole peg 
ADL's: move from self care to IADL's & Driving skills
34
Q

Rehab Phase: Tx

A

Focus: Maximizing Functional Abilities
Positioning: still prevention contractors (sleep positioning)
Splinting
Sensory Reeducation: Compensation, visual awarness (safety)
Exercise: more active vs passive
ADL’s: still push towards IADL’s
Work-related skills
Scar control: SPF, hats, cover ups, used year round
Pt./family education

35
Q

Dynamic Burn Splint: MP’s are in

A

Flexion

36
Q

Follow UP: Out pt OT or Burn Clinic

A 
Life Long 
Ongoing reconstructive/plastic surgeries 
Exercise 
Scar control
Splinting 
Positioning 
Work-Related Skills
37
Q

Psychosocial Issues

A 
Fear 
isolation
guilt 
frustration 
loss 
grief 
body image disturbance

618 Phys Dys 2 Quiz1 (4 decks)

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