Burns Flashcards
Burn on anterior neck
contracture tendency?
Anti-Contracture positioning?
- with neck flexion
- extend the neck, neck extension, and remove pillows
Burn on Axilla
contracture tendency?
Anti-Contracture positioning?
- Adduction
- 120 degrees abduction with slight external rotation, axilla splint or positioning wedges, watch for signs of brachial plexus strain
Anterior elbow
contracture tendency?
Anti-contracture positioning?
- Flexion
- elbow extension splint in 5-10 degrees flexion
Dorsal wrist
contracture tendency?
Anti-contracture positioning?
-wrist extension
-wrist support in neutral
volar splint
Volar wrist
contracture tendency?
Anti-contracture positioning?
- wrist flexion
- wrist cockup splint in 5-10 degrees flexion?
Hand dorsal
contracture tendency?
Anti- contracture positioning?
- claw hand deformity
- Functional hand splint, intrinsic plus splint, antideformity splint, or safe position splint with MP joints 70-90 degrees, IP joints fully extend, first web opening, thumb in opposition
Hand volar
contracture tendency?
Anti-contracture positioning?
- palmar contracture
- palm extension splint
Hip- anterior
contracture tendency?
Anti-contracture positioning?
- hip flexion
- prone positioning, weights on thigh in supine; knee immobilizer
knee
contracture tendency?
Anti-contracture positioning?
- knee flexion
- knee extension positioning and/or splints; prevent external rotation which may cause peroneal nerve compression
Foot
contrature tendency?
Anti-contracture positioning?
- foot drop
- Ankle at 90 degrees with foot board or splint; watch for signs of heel ulcer
Terminal device
movement?
intervention?
-humeral flexion with scapular abduction (protraction) on the side of amputation
-manually guide patient through motions
for transhumeral prostheses keep elbow unit locked in 90 degrees
wrist unit
movement?
intervention?
-Rotate TD to supination (fingers of hook up), midposition (fingers toward midline), or pronation (fingers down)
For uni-lateral amputation patient uses sound hand to rotate TD
For bi-lateral amputation rotate TD against stationary object, between knees, or with contralateral TD
-Have patient analyze the task and determine the most efficient approach for grasp (avoiding excessive or awkward movements)
Elbow unit
movement?
intervention?
-Depress arm while extending and abducting humerus to lock or unlock elbow mechanism.
Practice flexing and locking elbow in several planes
- Manually guide patient through motions. Begin w/ elbow unlocked, patient listens for click as lock activates. Have patient exaggerate movements initially, and use a mirror
-Use humeral flexion to flex the elbow; go beyond desired height, since the arm will drop with gravity pull as patient is in the process of locking the elbow unit.
Turntable
movement?
intervention?
-Rotate elbow turntable toward or away from body using sound hand.
With bilateral amputations push or pull against stationary object to rotate
superficial partial thickness burn second degree burn involves? healing time? intervention?
involves dermis and epidermis no grafting necessary heals in 7-21 days
-wound care and debridement sterile whirlpool and dressing changes, gentle AROM and PROM, edema control, splinting, occupational role activities and ADL’s
deep partial thickness burn second degree burn involves? healing time? intervention?
involves the epidermis and deep portion of the dermis healing time. sensation may be impaired, 21-35 days could lead to full thickness burn with infection
-wound care and debridement sterile whirlpool and dressing changes, gentle AROM and PROM, edema control, splinting, occupational role activities and ADL’s
full thickness burn
third degree burn
- involves epidermis, dermis, hair follicles, sweat glands, and nerve endings sensation is absent requires skin grafting-transplantaion of tissue or skin to another person
- first 72 hours dressing changes, splint at all times
- 5-7 days begin AROM, light ADL and meaningful activities
- when wounds are healed use massage, order compression garments, provide otoform/elastomer inserts
burns to hand
name all types of splints
- wrist 20-30 degrees extension
- mcp joints in 70-90 degree flexion
- ip joints fully extended
- thumb abducted or extended
- functional splint, antideformity splint, intrinsic splint, or safe splint
web space burn
splint?
C splint
hypertrophic scar
appears 6-8 weeks after wound closure compression garments should be worn 24 hours a day
electrical burns
check sensation
stages of wound healing
inflammation, proliferation, and remodeling
