Burns Flashcards
What is the “rule” for measuring burn size on adults?
The rule of 9’s.
- calculates the total body surface area of burns by dividing the body into 9s
1st degree burn is called…
superficial burn
superficial burns involve what layer of the skin?
superficial epidermis
A superficial 2nd degree burn is called…
superficial partial-thickness burn
A superficial partial thickness burn involves what layer of the skin?
epidermis and upper dermis
T/F: wet blistering occurs with a 2nd degree (superficial partial thickness) burn
True, wet blistering occurs
A deep 2nd degree burn is called…
deep-partial thickness burn
What level of pain is involved with a DEEP 2nd degree burn?
severe pain
What layer of skin is involved in a DEEP 2nd degree burn (deep-partial thickness burn)?
epidermis, deep dermis, hair follicles, and sweat glands
T/F: Deep partial thickness (deep 2nd degree burns) have a low risk of developing into a full thickness burn?
FALSE
- deep 2nd degree burns have a high risk of turning into a full thickness burn due to infection
What is a 3rd degree burn called?
Full thickness burn
What layers of the skin are involved in a 3rd degree (full thickness) burn?
- epidermis, dermis, hair follicles, sweat glands, AND NERVE ENDINGS
T/F: full thickness burns are painful
FALSE: full thickness (3rd degree) burns are not painful and have no sensation
What is the most severe type of burn?
Subdermal burn
What is exposed when an individual ha a subdermal burn?
underlying tissue (including fat, muscles, and even bone)
Examples of thermal burns
heat, flame, scald, cold
Examples of radiation burns
sunburns, x-rays, radiation therpay
2 types of electrical burns
High and Low voltage
- low voltage is more dangerous, because it makes it harder to withdraw a limb from the electricity
During the emergent phase (0-72 hrs after burn) what is critical?
sustaining life, controlling infection, and managing pain
What is involved in sustaining life during the emergent phase (0-72 hrs after burn)?
the risk of dehydration and hypo/hyperthermia
What is the purpose of wound dressings?
protect wounds against infection, superficially debride the wound, and provide comfort
During the acute phase, what is the focus of treatment?
infection control and grafts
What should be involved in the diet of someone in the acute phase of burn injury (72 hours after)?
high-protein and with proper hydration
OT role in the emergent phase (0-72 hours after burn) includes…
observation of burn sites, info gathering of PLOF, and splinting
What is the position the hand should be in after burn to this area?
Intrinsic plus position
Should the neck, elbow, and knee be in flexion OR extension following burn?
Extension (neck should be in neutral or with slight extension)
Shoulder/axilla should be in what position following burn?
abduction 100-120 degrees with slight ER
What degree should the wrist be positioned in following burn?
30 degrees extension
What degree should the MCP’s be positioned in following burn?
70 degrees flexion
What degree should the IP’s be positioned in following burn?
0 degrees extension
3 components of edema management
Elevation, AROM, wrapping
You are working with a patient with LE burns, what should you do before prolonged sitting EOB, standing, or walking?
apply compression wrapping to the LE to avoid pooling of fluid/blood
Following a skin graft operation what is key?
immobilization to allow for graft adherence
A patient is has completed their immobilization stage following a skin graft, what should you do next?
gentle AROM to avoid shearing
During the rehabilitation phase, what is important when addressing skin conditioning?
skin lubrication to prevent dry skin and massage to desensitize
A patient with a burn develops heterotopic ossification. What does this mean?
formation of bone in abnormal areas
A patient with a burn develops heterotopic ossification. What type of movement should you engage them in?
pain-free AROM to preserve joint movement.
- discontinue PROM/Passive stretching!!
What is pruritis?
persistent itching
what may help a patient with pruritis following a burn?
compression garments, skin lubrication, and use of cold packs
A patient has a dorsal hand burn. What precaution should you keep in mind?
Boutionniere precaution
How can you avoid Boutionniere deformity in a patient with a dorsal hand burn?
ROM should be as follows
- MP ROM with IPs in full extension
- IP ROM with MPs in full extension
T/F: a volumeter should be used to measure edema management for an individual with and open hand burn
FALSE, this should be avoided until wounds are closed
