Burn Depth
What does erythema mean?
reddening of the skin
Why is early ROM of the affected area so important for optimal recovery?
Reduce the chances of developing a contracture
According to the rule of 9's, what is the percentage of total body surface area of an adult's chest?
18%
OT's commonly splint in ____ position to manage tissue lengthening?
antideformity position
What are the three layers of the skin anatomy?
Epidermis, Dermis, Subcutaneous fat
When is the best time to educate the client and family about burns and the healing process?
Throughout the healing process
What chart is most accurate in calculating the total body surface area that has been affected by a burn injury?
Lund and Browder Chart
Why is proper positioning so important for a client with a burn?
Increased ROM and prevention of contractures
What classification of burn, goes to the tissue depth of the epidermis and much of the dermis?
Deep partial thickness burn
DAILY DOUBLE
A patient with deep partial-thickness burns has an extremely edematous right hand. The patient has multiple open wound areas on the dorsum of the hand and between the web spaces. What is the BEST approach for assessing the effectiveness of treatment in reducing swelling?
A. Take circumferential measurements of the forearms, wrists, palms, and digits.
B. Use a volumeter to measure water displacement of the forearms and hands.
C. Ask the patient to elevate the right hand above the level of the heart.
D. Compare differences in time in completing the Nine-Hole Peg Test.
Answer: A
According to the rule of 9s, what is the total body surface area of an infant's left and right legs?
28
What type of splint is used to increase function by providing a slow force to stretch a contracture or provide resistive force for exercise?
Dynamic or follow-up splint
These are the clinical findings of what kind of burn? : "Erythema: larger, usually broken blisters on skin with hair; on glabrous skin of the palms and soles of the feet; large possible intact blisters over beefy red dermis; severe pain to even light touch"
Deep partial thickness burn
When should an occupational therapist's initial evaluation occur in the acute setting?
Within the first 24 to 48 hours after hospital admission
What type of graft is made of processed human cadaver skin?
Homograft/Allograft
What are the contractures/difficulties we need to worry about when someone experiences a burn to the palm of their hand?
Fingers adducted and flexed, palm pulled inwards
What thickness burns are not able to naturally replace damaged skin cells, therefore needing skin graft surgery?
Deep partial thickness burns and full thickness burns
What type of splint is used after the graft phase when there is no sufficient ROM obtained with static positioning and exercise?
Static progressive or postural splint
You have an evaluation of a child that has experienced burns on 8% of their body. According to the rule of 9s, what part of their body was burned?
Both, left and right, thighs
OR
Both, left and right, medial portions of the arms
DAILY DOUBLE
An OTR® is working with a client who received significant burns to the elbow. The client presents with a soft-tissue contracture at the elbow and is noncompliant with the wear of an anterior elbow extension splint. What alternative would be BEST for effective treatment of the soft-tissue elbow contracture?
A. Ace wrap the splint on instead of using straps
B. Discharge the client from occupational therapy secondary to treatment noncompliance
C. Refer back to the plastic surgeon for surgery
D. Use serial casting to slowly stretch the tissue
Answer: D