Order the classifications of burns from superficial to subdermal
- First degree
- Superficial
- Second degree
- Deeper partial thickness
- Third Degree
- Full thickness
- Fourth degree
Describe a first degree burn
Only epidermis injured Dry skin No blisters Painful Epithelium regrows in 2-3 days
Describe superficial burns
Blisters Mild to moderate scarring Tissue below blister is wet Shiny Pink or red
Describe second degree burns
Partial thickness Superficial or deep pain mottled red edema blisters if superficial 7-10 days for regrowth if deep 3-4 weeks with scarring May require grafts
Describe deeper partial thickness burns
Waxy White Soft and elastic Sensitive to pressure Not sensitive to light touch Can heal without grafting Scarring moderate to severe Can convert to full thickness
Describe Third degree burns:
Full thickness Complete destruction of epidermis and dermis Debridement and grafting necessary Probable scarring Contractures and deformities
Describe full thickness burns
Hard
Dry
Tan
Sensation absent or diminished
Describe fourth degree burns
Damage to muscle tendon bone
High risk of amputation or loss of motor control
What are the seven primary objectives of an OT on a burn unit?
- Prevent deformity and contractures
- Reduce edema
- Maintain ROM
- Patient and caregiver education
- Interdisciplinary approach
- ADLs
- Psycho-social support
What are the 12 goals on a burn unit?
- Positioning to prevent deformity
- Faciliation of healing
- Prevention of scarring and enhancement of skin integrity
- Reintroduction to daily occu. performance activity
- Therapuetic exercises to increase range of motion and prevent deformity
- Progressive strengthening exercise
- Patient/family education
- Scar management
- Customized garment measuring and fitting
- Emotional support
- Community Resource
- Research and new idea development
What is the position of comfort?
T/F is this a good position?
Why or why not?
UE adduction and flexion
LE flexion
Plantar flexion with toes pulled dorsally
Intrisic minus/claw hand
FALSE not a good position often causes contractures
How can you help burn pt. manage pain?
Coordinate with scheduled pain meds
Pre-determine length of tx and stick to this
How do you manage edema in extremities for burn patients?
Elevation
MOvement(ROM)
Coban
When should a burn patient be fitted with a custom-made orthosis?
No later than 3 weeks after wound healing
How long should a custom-made garment be worn each day?
23 hours
How many months does a client where a custom-made orthosis?
12-18 months or until scar maturation
What are the seven strategies for managing burn scars?
- Scar massage
- Compression garments
- silicone
- ROM
- Excision of scar then grafting
- Steroid injections
- Laser surgery
How do silicon and pressure garments help burn patients?
- Depp massage breaks down matrix stretching the scar
- Prevents contractures
- Protects fragile skin
- Promotes better circulation of damaged tissue
- Decreases itching
- Reduces bulky, thick, hard scars
What is the role of hydrotherapy on a burn unit?
Removes loose debris and old topical antibiotics
Cleanses wound and surrounding areas
Why do some burn patients suffer peripheral neuropathy?
Localized nerve injury
Overstretching or overcompressing
Infection
symmetrical distal weakness
T/F Scar contracture is the primary cause of dysfunction
True
Define keloid scar
overgrowth of tissue outside of the border of the burn
Define hypertrophic scar
Overproduction of collagen within the borders of the burn.
What is eschar?
Dead coagulated skin
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Sleep24
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Bed mobility and Transfers6
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Orthopedics17
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Amputations and Orthotics28
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Spinal Cord Injury40
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Home safety and modifcations24
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Dysphagia13
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TBI42
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Burns33
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Sexuality and Disability14
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Geriatric Conditions and OT21
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Work Hardening and Vocational Training11
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Cancer OT and End of Life Care22
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Managing UE injuries44
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Adapted Driving/Driving Rehab13
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Degenerative Neurological Disorders21
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Stroke37
