Week 3 Burn Eval Tx Flashcards

1
Q

how do we manage wounds

A

wash with soap and water
debride lose nonviable tissue.
topical antibiotics to prevent infection

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2
Q

TF: we wrap fingers and toes all together

A

false, individually.

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3
Q

what is a basic burn cream

A

silver sulfadiazine

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4
Q

why use collagenase

A

enzymatic debridement for full thickness burns

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5
Q

why use silver nitrate

A

in place of silvadine in case of sulfa allergic patient

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6
Q

why use anticoat silver products or silver imprgenated gauze

A

antimicrobial

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7
Q

why use sulfamylon

A

to cover bone cartilage.

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8
Q

where do we use bacitracin

A

face and around the eyes

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9
Q

why do we start rehab right away

A

to prevent contractures .

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10
Q

what is the sum of stuff that leads to loss of function

A

wound contraction
prolonged immobilization
and scarring

leads to loss of function

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11
Q

during what phases of healing do we get issues

A

proliferation and maturation

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12
Q

why do we look at electrolytes

A

they can ooze out and we can get an imbalance. can have cramps and arrhythmia.

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13
Q

what happens to resting HR and BP

A

resting HR increase

BP decreases

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14
Q

why look at CBC

A

infection and blood loss

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15
Q

what are some things we do during evaluation

A
monitor vitals 
assess lines 
PROM and AROM 
hand function 
sensation and strength 
endurance
mobility
gait
balance
peripheral vascular integrity 
splinting and positioning
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16
Q

what must we consider with the mobility exam

A

burn location and where we put our hands.
dressings
avoid shearing forced (can touch, don’t shear)
compression and muscle pumping
vitals
gait belt

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17
Q

what happens to metabolic demand at rest with burn patients

A

it is higher, so you may need more breaks and longer rests.

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18
Q

thermoregulation in burn patients

A

impaired, may not tolerate activity and temperature well

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19
Q

how do we want to optimize healing time with patients after a burn

A

oral pain meds 60 minutes before

IV pain meds 15 minutes

20
Q

what do we want to do with electrical burns

A

cardiac monitoring, motor and sensory exam.

21
Q

how do we want to position patients

A

edema management and keeping them safe, but prolonged stretch positions with comfort and minimized contracture.

22
Q

do we want to sit in flexion or extension or pretty neutral

A

neutral

23
Q

what is the purpose of an elevating sling

A

attached overhead for edema management and contracture prevention

24
Q

why do we want to be careful with prolonged and excessive elbow flexion

A

limits vascular flow and there is a risk of contracture

25
Q

what is a leg elevating wedge

A

edema management, but riding foam, so watch for pressure injuries. (especially heals and lateral malleoli)

26
Q

what is the benefit of a towel or blanket roll

A

promotes scapular retraction and neck extension

27
Q

what caution must we consider with positioning

A

splints and positioning has the potential to cause skin breakdown if not used properly.

28
Q

how do we want to wrap to give compression

A

figure * ACE distal to proximal, moderate stretch and with 50% overlapping.

29
Q

what are some other things we want to consider with compression

A

pain control, edema management, and mobility

30
Q

what is the caution, and why might we want to remove after walking? what conditions?

A

arterial insufficiency
impaired LE sensation
congestive heart failure

(things with poor blood flow)

31
Q

when does ROM start

A

day 0, to prevent contracture

32
Q

what might contraindicate ROM

A

trauma or fracture

33
Q

how soon does contractile forces start within the skin

A

1-3 days

34
Q

position of comfort = position of ___

A

deformity

35
Q

What do we start with AROM or PROM

A

AROM

36
Q

what does blanching tell us

A

if it is white it is tight

37
Q

what are some good educational things to talk about with patients

A

if it is painful, it is right
painful, stretch more.
morning most difficult because shrinking at night (NIGHT SPLINT)

38
Q

what might key you in that the patient needs splinting at night

A

mornings are most difficult and tightest.

39
Q

is bleeding with stretching acceptable

A

yes, smaller amounts

40
Q

some benefits of early PT

A

participate in recovery
promotes normal sleep wake cycles
presents negative effects of bedrest
safe and improves outcomes (psychologically, physically, functionally)

41
Q

what are some perceived barriers

A

vents, time constraints, staff requirements, complexity of burn and surgery. medical lines and status and meds. DONT LET ANY OF THIS STOP YOU

42
Q

why is reconditioning and weakness so likely in this population

A

immobile and in catabolic states

43
Q

how long does the catabolic state last after a burn

A

months to years, still trying to heal

44
Q

who is at a higher risk of muscle atrophy, other than ICU people

A

burns

45
Q

what has been found to contribute early to critical illness myopathy and neuropathy

A

sepsis