Be Aggressive in Mobilizing Burn Wounds
Dana Nakamura OT
James H. Holmes IV MD
Burn patients in the intensive care unit should be seen on admission by the physical and occupational therapy team. The key to successful rehabilitation is early intervention. Scarring is virtually inevitable with major burns and therapy is integral to limiting its effect on patient outcomes. Initial assessments include determination of positioning and splinting needs, range of motion (ROM) and strength, prior level of functional mobility and activity independence, cognition, and ability to learn/participate in the therapy program. Early interventions include positioning and splinting, edema management, exercise, functional mobility/activity retraining, and patient/family education. Early intervention and anticipation of potential complications are critical to optimizing functional outcome. All members of the burn team need to be able to anticipate potential complications to be proactive and take a preventative approach to treating burn patients. Staff education with training in the roles of all team members and daily collaboration are important for smooth carryover of treatment plans.
Communication of therapy plans is vitally important so that all staff involved in the patient’s care understand the techniques and procedures used and the rationale for such. Patient and family education is also important to facilitate understanding of the therapy process and build rapport for a therapeutic relationship. It is imperative to communicate that “therapy” needs to continue 24-7 because the healing and scarring process is a continuous and relentless one. Communication can occur by a number of ways such as one-on-one teaching, in-services, written information in the medical record, on-line documentation, and photos/diagrammed instructions on bedside boards.