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Integumentary Care > Week 3 Burn Pathophysiology PT Considerations > Flashcards

Week 3 Burn Pathophysiology PT Considerations Flashcards

1
Q

what are some rehab requirements for burn centers

A

comprehensive program within 24 hours of admission, with one full time burn PT and OT, that gets minimum daily therapy session. burn care 7x/week, with competency based therapy. Therapists train at a minimum every 2 years.

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2
Q

what are some burn center referrals

A 
full thickness burns 
specialized areas like the face, ears, eyes, hands, feet, 
circumferential burns 
chemical burns
electrical burns 
significant fractures 
inhalation or airway burns 
kids under 1 years old
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3
Q

who makes up the team

A

physicians, students, NP, nurses, PT, OT, ST, social worker, chaplain, pharmacologist, dietician, respiratory therapy and recreational therapist.

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4
Q

what are some burns and some complex skin conditions

A

electrical injuries, scald, flame, flash, contact burns
steven johnson syndrome, TENS
necrotizing fasciitis, gangrene, frostbite

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5
Q

what is the most common type of burn

A

flame

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6
Q

seconds most common burn

A

scald

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7
Q

can you have a combo of burns

A

yes like scald and contact if it is a very thick liquid that will stick to the skin

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8
Q

how are we going to treat a burn size that is less than 10-20% TBSA

A

pain control, bandages, therapy like stretching, exercise, and mobility.

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9
Q

how do you treat someone with more than 10-20% TBSA burns

A 
airway, breathing and circulation 
pain control 
fluid resuscitation 
bandages and dressings 
therapy
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10
Q

what are the differences in treatment of full and partial thickness burns

A

full: therapy, surgical interventions, therapy
partial: therapy

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11
Q

what is the order of tissue, starting from most superficial and going to deepest

A 
superficial: epidermis 
dermis 
subcutaneous tissue 
fat
fascia
muscle 
bone
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12
Q

do you get pain and sensations with full thickness burns

A

no, recuasse you are burning the nerve endings, so you get no pain

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13
Q

how long does it take a superficial wound to heal

A

1-7 days

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14
Q

how long does it take for a partial thickness to heal

A

7 days - 1 month

deeper: 2-6 weeks, heals by scarring.

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15
Q

how long does it take for a full thickness burn to heal

A

can’t heal without surgery.

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16
Q

what happens during the inflammation phase

A

increased blood flow, vasodilation, increased capillary permeability.
immune response
edema, exudate production
pain

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17
Q

what happens during the proliferation phase

A

angiogenesis, collagen production, red, vascular tissue appears in the wound, epithelialization vs scar tissue formation, skin, scar contraction.

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18
Q

what happens during the maturation phase

A

collagen remodeling and scarring
capillary regression
scar flattens, softens, pales, itching subsides.

19
Q

what is the rule of 9s with adult bodies

A

head and each arm are 9%
each leg and the trunk are 18% (front and back)
the groin is 1%

20
Q

what is the rule of 9s for a Childs body

A

head and trunk 18%
arms 9%
groin 1%
legs 14%

21
Q

a patients palm accounts for what % of the body

A

1 %

22
Q

what can a burn diagram show us

A

depth of the burns and locations on the body

23
Q

TF: burns are usually uniform depth

A

false, they vary with depth size

24
Q

what is the zone of coagulation

A

center part, and the deepest part with dead vessels

25
Q

what is the zone of stasis

A

center

26
Q

what is the zone of hyperemia

A

increased swelling and blood flow around the wound

27
Q

a partial thickness burn in what zone can covert to a full thickness burn

A

zone of stasis

28
Q

what factors can contribute to a partial thickness becoming a full thickness

A

infection
edema
poor resuscitation of fluid
hypotension

29
Q

how can we do activity and edema management

A

early AROM
ace wrap dependent limbs
positioning and elevation
muscle pumps

30
Q

what is the appearance, blanching, sensation, healing time and risk of scarring and contracture for superficial

A

appearance: pink, red, wet
blanching: present
sensation: intact and painful
healing time: less than 3 days
risk of scarring/contracture: very low

31
Q

what is the appearance, blanching, sensation, healing time and risk of scarring and contracture for superficial partial thickness

A

appearance: pink, red, edema
blanching: present
sensation: intact
healing time: 3-7 days
risk of scarring/contracture: low

32
Q

what is the appearance, blanching, sensation, healing time and risk of scarring and contracture for deep partial

A

appearance: white, waxy, mottled, blochy.
blanching: diminished
sensation: limited light touch and pressure intact
healing time: 2-6 weeks
risk of scarring/contracture: moderate to high, may need skin graft

33
Q

what is the appearance, blanching, sensation, healing time and risk of scarring and contracture for full thickness

A

appearance: white, waxy, leathery, bright red, dark eschar
blanching: absent
sensation: absent, often painless
healing time: surgical intervention
risk of scarring/contracture: scarring with grafting only way to heal.

34
Q

what are some issues with electrical burns

A

they go very deep, and can travel very quickly. full thickness, sometimes down to the bone.can have a lot of necrotic tissues, and usually has an exit wound

35
Q

what kinds of things are you observing with a wound

A

location, tissues present, exudate, odor, edges, condition and color of peri-wound, inflammation and infection, edema and pain

36
Q

what are some pieces of a hands on wound exam

A

palpate the wound bed
size and depth
photograph it
test sensation, blanching, and vascular integrity.

37
Q

what is compartment syndrome

A

when distal circulation is compromised because of increased internal pressure. you get a tourniquet effect, with a loss of tissue elasticity.

38
Q

in what kind of burns do you get compartment syndrome

A

circumferential full thickness, and even partial or mixed thickness that causes an increase in pressure because of inflammation and edema.

39
Q

what are the symptoms of compartment syndrome

A

severe edema,
pain out of proportion
tingling and numbness
absent and diminished peripheral pulses

40
Q

what techniques are crucial for alleviating and avoiding compartment syndrome

A

edema management with slings, leg elevators and pillow, all while monitoring pulses.

41
Q

what is the medical management of burn related compartment syndrome

A

escharotomy. this is when they make an incision into the dermal layer to release the tension, usually through the burn tissue.

42
Q

what do you do for treatment is an escharotomy or fasciotomy is planned

A

defer PT until it is complete.

43
Q

after the escharotomy, what do we do

A

may have some bleeding, but we make sure there is dressing, compression (WITH RESTORED PULSES), no weight bearing restrictions, but may get pain.

Integumentary Care (26 decks)

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