Week 3 Burn Eval Tx

Question 1

how do we manage wounds

Answer 1

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

Question 2

TF: we wrap fingers and toes all together

Answer 2

false, individually.

Question 3

what is a basic burn cream

Answer 3

silver sulfadiazine

Question 4

why use collagenase

Answer 4

enzymatic debridement for full thickness burns

Question 5

why use silver nitrate

Answer 5

in place of silvadine in case of sulfa allergic patient

Question 6

why use anticoat silver products or silver imprgenated gauze

Answer 6

antimicrobial

Question 7

why use sulfamylon

Answer 7

to cover bone cartilage.

Question 8

where do we use bacitracin

Answer 8

face and around the eyes

Question 9

why do we start rehab right away

Answer 9

to prevent contractures .

Question 10

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

Answer 10

wound contraction
prolonged immobilization
and scarring

leads to loss of function

Question 11

during what phases of healing do we get issues

Answer 11

proliferation and maturation

Question 12

why do we look at electrolytes

Answer 12

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

Question 13

what happens to resting HR and BP

Answer 13

resting HR increase

BP decreases

Question 14

why look at CBC

Answer 14

infection and blood loss

Question 15

what are some things we do during evaluation

Answer 15

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

Question 16

what must we consider with the mobility exam

Answer 16

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

Question 17

what happens to metabolic demand at rest with burn patients

Answer 17

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

Question 18

thermoregulation in burn patients

Answer 18

impaired, may not tolerate activity and temperature well

Question 19

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

Answer 19

oral pain meds 60 minutes before

IV pain meds 15 minutes

Question 20

what do we want to do with electrical burns

Answer 20

cardiac monitoring, motor and sensory exam.

Question 21

how do we want to position patients

Answer 21

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

Question 22

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

Answer 22

neutral

Question 23

what is the purpose of an elevating sling

Answer 23

attached overhead for edema management and contracture prevention

Question 24

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

Answer 24

limits vascular flow and there is a risk of contracture

Question 25

what is a leg elevating wedge

Answer 25

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

Question 26

what is the benefit of a towel or blanket roll

Answer 26

promotes scapular retraction and neck extension

Question 27

what caution must we consider with positioning

Answer 27

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

Question 28

how do we want to wrap to give compression

Answer 28

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

Question 29

what are some other things we want to consider with compression

Answer 29

pain control, edema management, and mobility

Question 30

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

Answer 30

arterial insufficiency impaired LE sensation congestive heart failure (things with poor blood flow)

Question 31

when does ROM start

Answer 31

day 0, to prevent contracture

Question 32

what might contraindicate ROM

Answer 32

trauma or fracture

Question 33

how soon does contractile forces start within the skin

Answer 33

1-3 days

Question 34

position of comfort = position of ___

Answer 34

deformity

Question 35

What do we start with AROM or PROM

Answer 35

AROM

Question 36

what does blanching tell us

Answer 36

if it is white it is tight

Question 37

what are some good educational things to talk about with patients

Answer 37

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

Question 38

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

Answer 38

mornings are most difficult and tightest.

Question 39

is bleeding with stretching acceptable

Answer 39

yes, smaller amounts

Question 40

some benefits of early PT

Answer 40

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

Question 41

what are some perceived barriers

Answer 41

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

Question 42

why is reconditioning and weakness so likely in this population

Answer 42

immobile and in catabolic states

Question 43

how long does the catabolic state last after a burn

Answer 43

months to years, still trying to heal

Question 44

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

Answer 44

burns

Question 45

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

Answer 45

sepsis