Chapter 15 Burn Rehabilitation

Question 1

BURNS

1. Secondary to external agents (________, ________, chemicals, electricity, and radiation).
2. # 1 cause of accidental deaths in children under ________ years.
3. Leads to ________ state.

Answer 1

BURNS

1. Secondary to external agents (heat, cold, chemicals, electricity, and radiation).
2. # 1 cause of accidental deaths in children under 2 years.
3. Leads to hypermetabolic state.

Question 2

DEPTH/DEGREE

1. Superficial thickness (first degree): ________ only. red and painful, heals spontaneously in ________ to ________ days.
2. Partial thickness (second degree): ________ to ________ days to heal.
   2a. superficial: epidermis with ________; ________ layer remains intact.
   2b. deep: ________ involved with ________.
3. Full thickness (third degree): full ________ and ________ involvement, with possible fat, muscle, or bone affected. eschar forms and requires debridement with ________.

Answer 2

DEPTH/DEGREE

1. Superficial thickness (first degree): epidermis only. red and painful, heals spontaneously in 3 to 7 days.
2. Partial thickness (second degree): 7 to 21 days to heal.
   2a. superficial: epidermis with blistering; basal layer remains intact.
   2b. deep: dermis involved with blistering.
3. Full thickness (third degree): full epidermis and dermis involvement, with possible fat, muscle, or bone affected. eschar forms and requires debridement with grafting.

Question 3

Parkland Formula = ________ mL lactated Ringer’s solution × body weight in kg × TBSA% burned.
Administer ________ the ________-hour total over the first 8 hours, ________ over the next 8 hours, and the remaining ________ over the last 8 hours.

Answer 3

Parkland Formula = 4 mL lactated Ringer’s solution × body weight in kg × TBSA% burned.
Administer ½ the 24-hour total over the first 8 hours, ¼ over the next 8 hours, and the remaining ¼ over the last 8 hours.

Question 4

REHABILITATION GOALS
Limit loss of \_\_\_\_\_\_\_\_.
Reduce \_\_\_\_\_\_\_\_.
\_\_\_\_\_\_\_\_ management.
Prevent \_\_\_\_\_\_\_\_ with positioning/splinting: including capsular contractions or shortening of tendons and muscles which cross joints.

Answer 4

REHABILITATION GOALS
Limit loss of ROM.
Reduce edema.
Scar management.
Prevent contractures with positioning/splinting: including capsular contractions or shortening of tendons and muscles which cross joints.

Question 5

Scar management

1. ________ scarring: present at ≥________ months after burn injury with ≥________ mm in thickness.
2. more likely to occur if wounds take >________ weeks to heal.
3. usually matures at ________ years.
4. need ________ mm of pressure to counteract the contraction of a scar.

Answer 5

Scar management

1. hypertrophic scarring: present at ≥3 months after burn injury with ≥2 mm in thickness.
2. more likely to occur if wounds take >2 weeks to heal.
3. usually matures at 1½ years.
4. need 25 mm of pressure to counteract the contraction of a scar.

Question 6

POSITIONING TO PREVENT CONTRACTURE

1. ________ and ________.
2. Prevent dependent ________.
3. Special beds (Kin Air, Roho).

Answer 6

POSITIONING TO PREVENT CONTRACTURE

1. Extension and abduction.
2. Prevent dependent edema.
3. Special beds (Kin Air, Roho).

Question 7

Splinting – must be done in conjunction with mobilization

1. examples: resting hand splint, knee ________ with ________ of lower extremity, and elbow ________.

Answer 7

Splinting – must be done in conjunction with mobilization

1. examples: resting hand splint, knee extension with dorsiflexion of lower extremity, and elbow extension.

Question 8

COMPRESSION GARMENTS

1. decrease ________ scarring.
2. blood flow reduced with pressure on capillaries, causing reduced ________ formation.
3. ________ hours/day wearing schedule.

Answer 8

COMPRESSION GARMENTS

1. decrease hypertrophic scarring.
2. blood flow reduced with pressure on capillaries, causing reduced scar formation.
3. 23 hours/day wearing schedule.

Question 9

NUTRITION
2,000 to 2,200 calories/day.
Supplements: Vit ________, Vit ________, ________, copper, and manganese.

Answer 9

NUTRITION
2,000 to 2,200 calories/day.
Supplements: Vit C, Vit A, zinc, copper, and manganese.

Question 10

COMPLICATIONS
peripheral ________ and multiple ________.
bone/joint changes and ________.
heterotopic ossification: ________ is the #1 site.
________/kyphosis.
________/dislocation.

Answer 10

COMPLICATIONS
peripheral neuropathy and multiple mononeuropathy.
bone/joint changes and osteophytes.
heterotopic ossification: elbow is the #1 site.
scoliosis/kyphosis.
subluxation/dislocation.