603 Final P12: burns

What are the goals of OT in burn management?

prevent contractures, minimize scarring, preserve joint mobility and ROM, maintain ADLs, maintain good cardio function and strength, restore functional

What are potential areas of dysfunction in burn patients?

loss of ROM, strength, function, independence, decreased endurance, disfigurement, psychosocial issues

In burn patients, position of comfort is the position of?

deformity (fetal)

What is the ideal positioning of burn patients?

supine, with burn areas stretched using slings, towel rolls, pillows

positioning of anterior neck burn

shoulder roll, short mattress, foam wedge, no pillow

positioning of shoulders

90 abduction 24 hours/day, using slings or splints

positioning of palmar burns

extending palmar surface using rap king roll to back of hand or palmar extension splint

positioning of perineum burn

pillow between legs or blue foam abduction wedge to abduct legs and keep neutral rotation

positioning of posterior leg burn

knee extension using immobilizer or flat bed

positioning of ankles

neutral, heels off bed, using footboard, multipodus splint, pillows, or velfoam strapping

When does active & passive exercise begins with burn patients?

day of admission

How can OTs use stretch and massage with burn patients?

massaging with lotion helps soften scares; applied before, during, after stretch 2-3x/day

Describe active hypertrophic scarring

red, raised, firm, rough (whorl-like pattern)

When do contractures occur?

during the scarring phase

When do contractures develop?

as burned skin cannot grow/stretch, due to pulling forces in the scar

List some pressure dressings

ace wrap, coban, tubigrip

What are indications for splinting in burn patients?

protection of anatomic structures, preservation of skin graft integrity, prevention of deformity, restoration of function

In acute burn care, when should burns be immobilized and supported?

if tendons/joints are damaged

burn splints should be fabricated large enough to accommodate what?

edema

What are the phases of burn care?

acute --> wound healing --> rehabilitation --> reconstructive

During the wound healing phase, what kind of splint should be fabricated?

conforming splint with edges rolled or flared away with the skin

What is the most important factors of splinting in burns?

check fit of splint