Week 3 Burn Pathophysiology Special Considerations Flashcards
what are some complications of major burns and the PT implications
systemic effects of major burns tendon exposures heterotypic ossification amputations inhalation therapy CO poisoning face and neck burns
systemic effects of burn injuries happen when the burn is what % TBSA
over 15-30%
what are some systemic effects
effects that are not seen for 2-3 days after the admission that cascade to all organs and systems.
what is burn shock
combo of distributive, hypovolemic and cardiogenic shock.
what are some cardiovascular systemic effects
tachycardia
hypotension (decreased CO)
what are some hypermetabolic systemic effects
increased HR
increased nutritional needs because the body is in a state of catabolism
what are some pulmonary effects
lung inflammation and edema, and can lead to acute respiratory distress syndrome
what are some immune system problems
compromise due to absence of that skin barrier and the inflammation that occurs
do you get inhalation injuries fro hot air or poisons/chemicals
chemicals
what can PT do for inhalation injuries
mobility, positioning, posture, breathing, airway clearance things.
what is CO poisoning, and what happens to cardio things
carboxyhemoglobin COHb (0-5% normally)
HR and RR increase
you get arrhythmia and MI
BP decreases
TF: with CO poisoning, you get a true elevated SpO2
false, it is falsely elevated
what is delayed neuropsychiatric syndrome
cognitive/personality changes, Parkinsonism, and spontaneous resolution in 1 year. (thanks to CO poisoning)
what is the risk of deep dorsal hand burns
risk of injury to extensor hood
what do we want to avoid with deep dorsal hand burns
composite fist flexion until it is closed.
what position do we want the hand in
MP flexion with IP extension
what are some implications of an achilles tendon burn
tendon damage, needs splinting, and prolonged low load stretch
what is heterotypic ossification
formation of bone in soft tissue around a joint, that happens with trauma, SCI, burns…
in burn populations, where is the most common spot for HO
elbow
what happens to ROM and end feel with HO
decreased, firm and hard end-feel
with HO, what positions do you normally lose
forearm supination, then elbow flexion and extension
TF: the pain is usually in proportion to the injury with HO
false, out of proportion
TF: you always see HO on x-ray
false, not in early stages
when is the average time of onset with HO from the injury
12 weeks
how do PT’s manage HO
not aggressive ROM
start with patient AROM that they can tolerate.
do not push past end range
surgical intervention after 1-2 years.
when might one have an amputation
electrical burn, frostbite, deep burns, infection
what is crucial for limb salvage
strength and sensation assessment
how do we manage the residual limb
wrapping, desensitization, HEP, positioning, splinting, ROM management and edema management.
