PTA Acute Care - Burns Flashcards

Question

What causes Neuropathy in the burn patient?

Answer 1

Local - compression bandages - poorly fitting splints - bad positioning Poly - idiopathic

Answer 2

loss of ROM when scars cause contractures or are keloid | - watch positioning

Answer 3

* thermal - flame, explosion, contact with hot metal or liquid * electrical - lightning, electrical waves * chemical - acids and alkalids * UV radiation - sunburn

Answer 4

entrance wound | exit wound

Answer 5

neutralize it | usually water

Answer 6

classification of depth * Superficial * damage only to epidermis * (sunburn) * painful - nerve ending on epidermis * heals on its own * no scar * treatment is cover and manage pain

Answer 7

classification of depth * Partial Thickness Burn * Superficial partial-thickness burn - Damage through epidermis and into the papillary layer of dermis - Moist skin and blister that need to be evacuated because they may delay healing - Heal in 7-10 days with minimal scarring - Extremely painful due to exposed nerve endings * Deep partial-thickness burn - Damage of dermis down into the reticular layer - Appears as mixed red or waxy white color. The deeper the injury the more white it will appear - Marked edema and large amt of evaporative water loss - Heals in 3-5 weeks if doesn’t get infected - Development of hypertrophic and keloid scars frequent

Answer 8

classification of depth * Full Thickness Burn - All epidermal and dermal layers are destroyed completely; subcutaneous fat layer may also be destroyed - Skin deadly white to dark; charred brown - Characterized by hard, parchment-like eschar - Peripheral vascular system damaged - Surgery often required to remove eschar - Grafting necessary - No pain (not as much as 1st and 2nd anyway)

Answer 9

classification of depth * Subdermal - Destruction of all tissue from the epidermis down to and through the subcutaneous tissue. Fascia, muscle, and bone may be damaged - Often due to electrical burn - Extensive surgical and therapeutic management is required

Answer 10

how to calculate the extent of the body surface involved in the burn - Allows a rapid estimate of extent of body burned - Divides body surface into areas of 9% or multiples of 9% of total body surface - UEs and head 4.5% front and back each - LEs 9% each front and back - Trunk 18% front; 18% back

Answer 11

1. removal of heat source 2. establish adequate airway (CPR as needed) 3. if chemical, flush with water

Answer 12

1. Maintain airway (ventilator) 2. Prevent cyanosis; shock; hemorrhage 3. Establish extent and depth of burn injury 4. Prevent/reduce fluid loss -> IV solutions 5. Insert catheter 6. Clean wounds -> escharotomy for circumferential burns of extremities or chest to prevent compression and constriction of blood flow 7. Assess injury 8. Prevent pulmonary and cardiac complications

Answer 13

- Prevent infection: isolation and sterile techniques; use of silver medications - Clean wound: possible whirlpool - Open or closed (bandaging) treatment - Debridement * Surgical debridement: excision of eschar * Sharp debridement: using forceps and surgical scissors * Enzymatic debridement: application of proteolytic enzyme ointment that digests necrotic tissue - Increased caloric intake - Warm room

Answer 14

made the Rules of Nines more accurate. - modified the Rule of Nines to account for a continuum of age and to accomodate for growth of different body segments - they have a fancy chart

Answer 15

* wound care * positioning * splinting * exercise * gait training (functional training) * fitting of post-burn compression garments * scar management * HEP and positioning/splinting program

Answer 16

- Clean wound: possible whirlpool - Open or closed (bandaging) treatment - Debridement * Surgical debridement: excision of eschar * Sharp debridement: using forceps and surgical scissors * Enzymatic debridement: application of proteolytic enzyme ointment that digests necrotic tissue

Answer 17

In such a way as to: * Minimize edema * Prevent tissue destruction * Maintain soft tissues in elongated state * Splint to assist with preventing contractures or ROM

Answer 18

Because they are mostly burned on the front * Neck: extension and no rotation * Shoulder: abduction (90 degrees); external rotation; horizontal flexion (10 degrees) * Elbow and forearm: extension with supination * Wrist: neutral or slight extension * Hand: finger and thumb extension (palmar burn) * Trunk: straight postural alignment * Hip: neutral extension/flexion; neutral rotation; slight abduction (perpendicular to that ASIS line) * Knee: extension * Ankle: neutral or slight dorsiflexion; no inversion; neutral toe extension/flexion

Answer 19

ROM exercises * Active or active assistive if possible; passive and stretching occasionally - Difficult with pain level but must be persistent; time sessions with pain meds - Must avoid exercise to grafted areas for at least 3-5 days or until okay by surgeon - Not performed on areas of exposed tendons Strengthening * Exercises in rehab stage - Monitor vital signs closely and gradually progress to aerobic exercise

Answer 20

Gait Training | - at the earliest stage possible

Answer 21

to prevent hypertrophic scarring

Answer 22

- applies compression garment to prevent hypertrophic scarring - massage scars to soften the areas

Answer 23

- Infection - #1 - Respiratory b/c of inhalation injury (CO poisoning) - Metabolic complication (patient’s body cannot keep up) - Cardiac function (decreased CO)