The client with severe burns will be hospitalized for weeks or months. Burn wounds often require painful dressing changes, surgery and grafting. Preservation of function and prevention of complications are the priorities of care. A multidisciplinary team will care for the burn patient. The team may consist of nursing staff who provide twenty four hour care, case management, pulmonary specialists, medical providers, surgeons, physical therapists, occupational therapists, nutritional specialists and spiritual care providers. The documentation can be overwhelming and legal nurse consultants can help to organize and interpret the medical records.
Treatment of burn injury is dependent on the type of injury to the skin and underlying tissue. The skin consists of two layers. The upper layer of skin is the epidermis, the deeper layer is the dermis. Burn injuries are classified according to depth:
During hospitalization, burn wounds are measured and assessed daily. Restoring the skin by natural healing or grafting starts with the removal of dead skin, called eschar. The damaged skin may be removed by the application of topical enzymes, hydrotherapy or surgical debridement. Patients who require surgery are usually taken to the operating room within the first five days after injury. This reduces the risk of infection. If skin grafting is required, it may be from the patient’s unburned skin, called an autograft or from a tissue bank, called an allograph. Dressings are applied post-op and changed according to protocol.
The client with burn injuries will be discharged from the acute care hospital when life threatening complications have resolved and wounds are almost completely healed. Additional treatment at a rehabilitation hospital may be needed for weeks or months. A multidisciplinary team is needed just as in the acute care hospital. Physical and occupational therapy will be provided to help the client achieve as much function as possible and adapt to changes in lifestyle. Following discharge, pressure dressings and garments may be worn on an outpatient basis to prevent contractures and minimize scarring. Reconstructive and cosmetic surgery may be performed many years after the initial injury. Attorneys may find that their client has unrealistic expectations about their appearance or health. The client may never return to their pre-injury status. They can be physically disabled. Psychological support may be needed for years to help the client cope with their stress and trauma.
This month we are discussing Burn Injuries. The blog topics for this month are:
- Case Study: Burn Injuries (3/4/16)
- Burns: Initial Treatment (3/11/16)
- Burns: Long Term Treatment (3/18/16)
- Burns: Complications (3/25/16)
Note: To see all posts in this topic, click here