Burns Flashcards
What is the rule of 9’s for identifying amount of body covered with a burn?
head/neck = 9% arms = 9% each legs = 18% each anterior trunk = 18% posterior trunk = 18% perineum = 1%
What % of the body covered with burns identifies them as critical?
critical = 10% of body with 3rd degree burns and 30% or more with 2nd degree burns
- complications common
What is a partial thickness burn?
partial thickness can be either superficial or deep, but this means that epidermis AND dermis are both affected
If only epidermis is damaged, what kind of burn is that?
first degree burn; no blistering
What is affected in a second-degree burn?
2nd degree burn = partial thickness burn (either superficial or deep)
What is a full-thickness burn?
3rd degree burn: complete destruction of epidermis, dermis, and subcutaneous tissues
- may extend into muscle
What is the leading cause of death in a burn injury?
infection -> gangrene may develop
Loss of sebaceous glands in skin d/t a burn can result in what issues?
drying, cracking of a wound
- thus need to protect with moisturizing cream for epidermal burns
Discuss the transformation of scar color as it heals.
initially is purple or red, then eventually becomes white
What are the three phases of wound healing?
1) inflammatory phase (redness, edema 3-5 days)
2) granulation phase (collagen laid down)
3) maturation phase (scar reforms)
6-12 wks = immature, pink scar
- reformation can take up to 2 years
What does emergency care for a burn look like?
immersion in cold water - if less than half of the body is burned and injury is immediate, cold compress may be used
cover burn with sterile bandage/clean cloth, NO ointments
T/F: shock often occurs as a result of a burn.
true - often need fluid replacement therapy to prevent and control shock
What is an allograft?
use of cadaver skin for a graft
T/F: Excessive immersion is the first line of burn wound debridement.
false, it’s contraindicated
What are the overall goals of rehab for burn victims?
- limit loss of ROM
- reduce edema
- prevent predictable contractures through positioning/splinting
- prevent or reduce complications of immobilization
When does anti-contracture positioning and splinting begin?
day one, continues for many months
How should you position the neck?
common for it to be in flexion
- get it in hyperextension and position with a firm plastic cervical orthosis
How should you position the shoulder of a burn victim?
abduction, external rotation, flexion (position with axillary “airplane” splint)
How should you position the elbow after a burn?
in extension and supination (posterior arm splint)
What position should you have the hand in after a burn?
intrinsic plus position (lumbrical action position)
- wrist ext, MP flexion, PIP/DIP extension, thumb abduction
- use resting hand splint
How should you position the hip and knee after a burn?
hip = extension and abduction, neutral rotation
knee = extension with posterior knee splint
How should you position the ankle after a burn?
dorsiflexion with foot-ankle in neutral via plastic AFO
How should you attempt to control edema after a burn?
elevate extremities, ACTIVE ROM
- need to take all joints through PROM prior to achieving AROM
How long should you wait after postgrafting to allow grafts to heal before you begin exercise again?
3-5 days
What does scar management involve?
- massage/application of moisturizer
- regular massage/touching of scars to dec. sensitivity
- pressure garments to reduce keloids
