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MU PT 7890 - Case Management I, Burn Rehabilitation
The learner will be able to:
1.
Review anatomy of skin; diagram and label a cross section. Name 5 functions of skin.
2.
Relate depth of burn to the layers and structures of the skin, circulation, appearance, presence of pain or
edema. Correlate current burn depth terminology to old terminology, i.e. 1st to 4th degree. Compare
Pressure Ulcer wound staging to the classification system used to describe burns. State approximate time
for healing for burns in a patient without systemic complications.
(O’Sullivan 5th ed. p.1094, T-27-2, Bottomley 3rd ed. p.366, Fig.14-1)
3.
Explain how a deep partial can convert to a full thickness burn.
4.
Differentiate types of burns based on cause; describe their initial appearance.
5.
Explain how an inhalation injury may be recognized before clinical respiratory symptoms set in. What
are the possible sequellae of this injury?
6.
Given a patient description, diagram, or picture, evaluate burn injury by percent, depth and severity using a
Lund and Brouder Chart as well as The Rule of 9's.
7.
Review how the major systems of the body respond to either direct burn injury or stress, and the
ramifications of common complications of burn injuries.
8.
Discuss at least five factors that determine the seriousness and the prognosis of a burn injury. For an
uncomplicated burn recovery, estimate time to wound closure, based on % total body surface area
(TBSA)
9.
Name members of a typical burn team, and identify each person's function.
10. Demonstrate recognition of the problems of those working with burn patients. How would working on a
burn unit be different compared to other PT settings?
11. Name basic principles of early medical care of a patient with a major burn and aspects that a PT could be
involved with.
12. State reasons for performing escharotomy.
13. Name two methods of controlling infection in a patient with a major burn.
14. Discuss purposes and application of hydrotherapy in burn care: devices, temperature, additives, duration,
precautions, cleaning equipment. Discuss precautions or contraindications for use of hydrotherapy for a
burn patient.
15. Recall (from the wound unit) different methods of debridement, precautions and contraindications.
Understand that for the burn patient, it is more likely that surgical debridement will occur, therefore it
would occur under more controlled conditions. There is typically more urgency to debride a burn,
compared to the timeframe of managing a chronic wound.
16. Correctly position or describe proper (bed) positioning for all joints, considering location of burn. Explain
how placement of a mattress can affect bed positioning.
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17. Determine need and select appropriate splints for shoulder, hand (dorsal and palmar/volar), elbow, hip,
knee and ankle, other joints. Explain the use of a neck roll, spine roll, axillary rolls.
(O’Sullivan; Campbell p.1034-1038)
18. List sources of skin graft materials and use correct terminology to describe them.
Discuss "harvest" of skin (ST and FT), use of skin substitutes and synthetic dressings, graft methods, care
of donor sites.
19. Recognize a graft that has taken. Describe it, and discuss resumption of body movement.
20. Describe principles of exercise applied to burn patients relative to a) maintenance of range and strength, b)
endurance, c) nutritional status, d) pain, e) wound healing, f) grafting.
Describe the relationship between end ROM and scar color when performing ROM.
(O’Sullivan; Campbell p.1038-1042, p.1046-1049)
21. Recommend compression garments and other devices such as silicon inserts, and plastic face mask
(alternative to garment face mask), being able to include a) rationale, b) time to apply, c) amount of
coverage to provide adequate compression, d) location of zippers, hook-and-loop closures (Velcro) on
any garment, given a patient description. Measure properly for elastic burn compression garments for all
parts of the body.
(O’Sullivan, Campbell p.1042-1045)
22. Teach patient and family to don, doff, launder, and care for elastic compression garments. Educate patient
and family about wearing schedule, number of garments needed, when to replace, and when/why remeasuring is needed.
23. Teach skin care after wounds are closed: management of pruritis, small areas of breakdown, stretch
discomfort.
24. Explain the pathophysiology of burn scar development and hypertrophy. Recognize and describe the
mature burn scar that has a desirable appearance. Distinguish hypertrophic scarring from keloid
formation. Describe ethnic differences in scar formation.
25. Discuss follow up care of the burn patient; management of contractures, scars, weakness. ADL problem,
psychological considerations.
26. Discuss long-term management of the burned child.
27. Demonstrate familiarity with methods of helping burn patients deal with stigma, curiosity.
28. Explore challenges of caring for a person who has a criminal charge against him/her.
29. Always note fire exits in buildings; rehearse a fire plan with roommates or family. Demonstrate awareness
about fire safety, and how this may relate to care settings, and how PTs may become involved in public
education about fire prevention.
MSH EP MUPT Rev. 85, 89, 96, 00, 03, 06