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Medical Conditions II > Thermal Injuries > Flashcards

Thermal Injuries Flashcards

1
Q

Burn Causes include:

A
  • thermal
  • chemical
  • electrical
  • radiation
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2
Q

burns are ____ injuries

A
  • multi-system

- especially if burn is greater than 25% TBSA

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3
Q

TBSA

A

total body surface area

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4
Q

thickness of burn determines_____

A

-extent of tissue damage

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5
Q

Hypertrophic scarring can result from_____

A

-partial- and full- thickness burns

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6
Q

Burn Classifications

A
  • superficial partial thickness
  • deep partial thickness
  • full thickness
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7
Q

Sunburns are a type of ____

A

1st degree burn

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8
Q

Superficial Partial Thickness

A
  • epidermis and dermal papillae (can involve some of basal cell layer)
  • 2-3 weeks to heal (re-epithelialization)
  • no scar
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9
Q

Superficial Partial Thickness S/Sx

A
  • erythema
  • wet
  • shiny
  • surface
  • edema
  • painful
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10
Q

Deep Partial Thickness

A
  • significcant damage to dermis
  • 3-4 weeks for healing with scar tissues (may hypertrophy and contract)
  • may need skin graft
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11
Q

Deep Partial Thickness S/Sx

A
  • erythema
  • blisters
  • white
  • waxy
  • pliable
  • pain to deep pressure
  • cold
  • may be insensitive to light touch
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12
Q

Full Thickness

A
  • epidermis and dermis destroyes
  • possible subq also
  • skin graft to heal
  • scar may hypertrophy and contract
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13
Q

Full Thickness S/Sx

A
  • brown/black, deep red, white
  • dry surface
  • edema
  • painless
  • insensate
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14
Q

Rule of Nines

A
  • assessment of burn size
  • arms/head=9% each
  • Legs, ant/post trunk=18% each
  • genitals=1%
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15
Q

Rules of Nines for Kids

A
  • head=12%
  • trunk ant/post=18%
  • arms=9%
  • Legs=16.5
  • genitals=1%
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16
Q

Burn Impairments

A
  • shift of body fluids to interstitial spaces
  • loss of tissue
  • loss elasticity
  • scar hypertrophy
  • scar contraction
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17
Q

Capillary walls during injury

A
  • more permeable
  • fluid flows out of vessels to interstitial space
  • take in nutrients, WBC and oxygen to injured area
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18
Q

Burn Intervention

A
  • Airway & Breathing
  • Fluid Resuscitation
  • Escharotomy
  • Fasciotomy
  • Nutrition
  • Pain management
  • wound management
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19
Q

Escharotomy

A

-release of scar tissue

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20
Q

Fasciotomy

A

-release of fascia

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21
Q

Burn Surgical Management

A
  • skin graft

- muscle flap

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22
Q

Skin Graft

A
  • full thickness burns require (unless very small)

- large area burns require graft (regardless of depth)

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23
Q

Graft Site

A

-location of burn that will be covered by homograft or autograft

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24
Q

Donor Site

A

-area that contributes the skin in autograft

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25
Autograft
-from another part of same body
26
Allograft
-graft from same species (cadaver or other person)
27
Heterograft
- (zenograft) | - from another species (pigskin)
28
CEA
- Cultured Epithelial Autograft | - skin of pt grown in lab
29
Integra, Apligraf, dermagraft
-dermal replacements
30
Sheet Graft
- more cosmetically appealing - requires larger donor site - always used on face and hands
31
Meshed Graft
- can be expanded | - waffle-like appearance
32
Burn Rehab Focus
- positioning - splinting - ROM - function/gait - ADLs - Scar Management -START IMMEDIATELY!!! DAY ONE!!!
33
Scar Formation
- deep wounds heal with scar tissue - fibrous tissue replaces normal tissue - goal: minimize hypertrophic scars
34
Position of comfort is _____
the position of deformity
35
Position to prevent:
- contractures - decubitus ulcers - control edema
36
Indications Splinting
- prevent contractures - protect exposed joints/tendons - when ROM is decreasing - 4-5 days post graft to immobilize graft area
37
Position for Burn pts
- Vitruvian Man | - (da Vinci)
38
Functional Potential of hand
(safe, intrinsic plus) - slight wrist ext with ulnar deviation - MCP at 90* - IP at 0* - Thumb IP 0*-some flexion - Thumb opposition
39
ROM & Ex's goals
- prevent contractures - joint integrity - maintain tendon gliding - prevent adhesions - reduce edema
40
Contractures can form in ____
1-3 DAYS
41
ROM most effective during____
bathing
42
ROM is usually ____
Painful
43
__/10 is highest amount of pain pt should have during therapy
4/10
44
ROM/Ex's Precautions
- edema - med equip - IV's - tubes - exposed joints/tendons - Heterotopic ossification - associated injuries - escharotomy/fasciotomy - new autograft sites - unstable/fragile autograft sites - neuropathies - cellulitis
45
Heterotopic Ossificatoin
- accum of unstructured bone around joint - sudden dramatic decrease in ROM - specific joint pain - only AROM until surgically removed
46
Prevention of HO
- at elbow, limit ex's to AROM or gentle AAROM | - (not PROM)
47
Mobility Goals
- increase functional independence - increase ROM, strength, endurance - prevent DVTs - improve pulmonary status - prevent postural hypotension
48
Mobility Options
- bed mobility - transfer training - cardiac chair - up to chair - ambulation (limit use of AD)
49
Scar management
- ROM/Ex's - functional mobility - compression therapy/garments - scar massage - modalities
50
Function of Compression Therapy
- control of hypertrophic scarring - promotes healing - assist w/ venous return
51
Indications for Compression therapy
- partial- or full-thickness burns - can initiate with minimal open areas (still have bandages on) - measure for custom garments after temporary compression has been used
52
Types of Temporary Compression Therapy
- ACE wraps - compressogrip/tubigrip - support hose - foam neck collars - coban - isotoner gloves
53
custom compression garmets
- name brand - must be measured for them (after graft healed) - 25-30 mmHg pressure
54
Phases of PT Burn Management
- Emergent and resuscitation phase - Acute phase - rehabilitation phase
55
Inpatient Rehab follow up
- rehab unit - outpatient - home health - vocational rehab - work hardening
56
Burn Outpatient Assessment
- ROM (joint by joint) - Scars - Pressure Garment/splint - ADL/Mobility - Activity level (back to work/sports/hobbies/school) - Psycholosocial Adjustments - Complications (pruritis, sleeplessness)
57
Psychological Issues
- PTSD - depression - feelings of guilt - anxiety - re-integration back to society
58
Supportive Services
- family support groups - burn survivor support group - burn camp - community activities & education - the american burn association - the phoenix society - the world burn congress
59
PT during Emergent Phase
- control edema - AAROM - mobility - positioning/splinting - ADL/Transfers
60
PT during Acute Phase
- splinting/positioning - AROM - WB and Ambulation - ADL - graft and donor site management - discharge planning
61
PT during Rehab Phase
- Skin care - scar eval - pressure garmets - ROM (AROM, PROM) - ADL - Strength/endurance - Therapeutic modalities - school/work function

Medical Conditions II (34 decks)

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