Burns Flashcards
Superficial (1st degree) burn
Superficial epidermis
Pain is minimal to moderate; NO blistering, NO erythema
Superficial burn healing time
3-7 days
sunburn or coffee/hot soup spill
dry, redness
Superficial burn tx
elevation
keep it clean
aloe or moisturizer to reduce dry and itchy skin
Superficial partial thickness (2nd degree) burn
epidermis and upper dermis layers
pain is significant
wet blistering and erythema
Healing time for superficial partial thickness burn
1-3 weeks
curling iron/severe sunburn
Superficial partial thickness burn tx
wound care
AROM to preserve jt fx and improve circulation
protective garments
sunscreen
acknowledge pts pain
coordinate tx with pain meds
Deep partial thickness (deep 2nd degree) burns
deep reticular dermis
Epidermis, deep dermis, hair follicles, sweat glands, and most painful
pain severe, even to light touch
erythema with or without blisters (red and white)
hypertrophic scar risk is high
Hypertrophic scar
a thick raised scar
compression therapy until scar matures
scar gel pads
Healing time for deep partial thickness burn
3-5 weeks
most painful
can turn into a full thickness bc of infection
typically caused by FIRE
TX for deep partial thickness burn
frequent AROM
elevate
splints
vascular support garments
silicone inserts to manage hypertrophic scars
lubrication to healed skin
prolonged stretch to contracted jts
ADLs
psych referral if needed
team collaboration/intraprofessional collaboration
Full thickness (3rd degree) burn
Subcutaneous tissue
epidermis, dermis, hair follicles, sweat glands, & NERVE endings
pain free, no sensation to light touch
pale and non blanching
peripheral pain
Healing time for full thickness burn
variable, could take multiple months
hypertrophic scars
chemical burns/extreme heat
graft needed
Tx for full thickness burn
skin graft
positioning/immobilization
exercise despite pain
vibration for itching
educate on skin precautions
support/pressure garments
use inserts and overlays to manage concave areas
peer support group
return to recreation, work, school, fam, and community responsibilities
Subdermal Burn (4th degree)
full thickness burn with damage to tissue (fat, muscles, tendon, or bone)
charring present, with exposed fat, muscles, tendon or bone may be present
Healing time for subdermal burn
variable healing time
amputation or reconstruction surgery might be needed
electrical burn/house fire
no pain but peripheral nerve damage
Tx for subdermal burn
deep tendon massage
AE
prosthetic fitting and training
counseling or water therapy for PTSD
memory retraining
peer support group
work retraining if unable to return safely to previous job
Dorsal burns to the hand commonly results in deformities
thumb webspace contractures
loss of motion at MP, IP and composite finger flex
claw hand
boutonniere deformity if extensor tendons were damaged
Palmer/volar burn lead to
limited thumb, finger, and composited extension due to the hand being in a fit position
When applying dressings, what should you do to prevent restricted movement?
wrap the digits individual from the hand
Why should you encourage mobilization of non-burned areas?
to avoid weakness from disuse
AE/AD that help with grasp
built up handles
universal cuffs
Burn stages
Emergent
acute
Skin grafting
rehab
Burn stage: emergent
first 72 hours after a burn
splinting in anti deformity positions
infection control/temp control
fluid resuscitation
resp mangement
edema forms = escharotomy
edema can cause compartment syndrome
compartment syndrome
painful build up of pressure around muscles
