burns Flashcards
(25 cards)
superficial burn
superficial epidermis only
- minimal pain and edema, no blisters
- healing time is 7 days
superficial partial-thickness burn
- involves epidermis and upper portion of dermis
- red, blistering, wet
- painful, no grafting necessary, heals on own
- 7-14 days
deep partial thickness burn
involves epidermis and deep portion of dermis, hair follicles, and sweat glands
- red, blotchy, white
- severe pain
- sensation may be impaired
- 21-35 days
- may requires skin grafts
- deformities may develop
full thickness burn
- epidermis and dermis are completely damaged; hair follicles, sweat glands, and nerve endings also involved
- white, waxy, leathery, nonelastic
- absent sensation
- hypertrophic scar
- healing can take months
rule of nines
method for assessing burn wound size
emergent phase of OT evaluation of burns
- initial burn to 72 hours
- medical management to stabilize
- OT may not be included
acute phase of OT eval of burns
- continues until wounds are closed
- can last 1 week to month
acute phase OT eval
- profile
- ROM
- cognitive screening
- pain
- sensation when wounds are healed
- strength when wounds are healed
- ADL
acute phase OT intervention
- fabrication of anit-deformity orthosis
- ROM contraindicated
- gentle AROM/PROM (AROM preferred)
- edema control
- ADL not a focus here
- patient/family education
rehab phase of OT eval
- continues until scar maturation
- eval the same as acute
rehab phase OT intervention
- focus is to return person to their prior level of functioning and includes A/PROM to prevent contractures & passive stretching to end range
- strengthening
- scar management once healed (at risk for hypertrophic scarring)
- sensation (desensitization)
- role activities and ADLs
psychosocial
routine for scar management
- massage
- AROM
- pressure therapy
guidelines for pressure therapy
- compression can be applied when wounds are healed
- wearing schedule should start in 2 hour intervals to 23 hours daily
- custom-made garments (worn all day except bathing)
- custom garments worn for 1-2 years until scars mature
hand orthosis for burns to the hand or dorsal hand
- wrist in 20°- 30° extension
- MCP joints in 70 ° flexion
- IP joints full extension
- thumb abducted and extended
burns to the volar surface of the hand which results in flexion contractures:
- palmar extension orthosis
- wrist in 0°- 30° extension
- MCP joints in neutral to slight extension and abducted (monitor collateral ligament)
- IP joints full extension
- thumb abducted and extended
position for burn on anterior neck and contracture risk
- remove pillows
- use half mattress to extend neck
- neck extension splint or collar
- risk for neck flexion contracture
position for burn on axilla and contracture risk
- 120° abduction with slight external rotation
- axilla splint or positioning wedges
- watch for signs of brachial plexus strain
- adduction contracture risk
position for anterior elbow burn and contracture risk
- elbow extension splint in 5°-10° flexion
- flexion contracture risk
position for dorsal wrist burn and contracture risk
- wrist support in neutral
- wrist extension contracture risk
position for volar wrist burn
- wrist cockup splint in 5°-10° extension
- wrist flexion contracture risk
position for hand dorsal burn
- functional hand splint with MP joint 70°-90°
- DIP joints fully extended
- first web open, thumb in opposition (safe position)
- claw deformity contracture risk
position for hand volar burn
- palm extension splint MPs in slight hyperextension
- palmar contracture cupping of hand
position for hip-anterior burn
- prone positioning
- weights on thigh in supine
- knee immobilizers
- hip flexion contracture
position for knee burn
- knee extension position and/or splints; prevent external rotation which may cause peroneal nerve compression
- knee flexion contracture
