SUB ACUTE burns

"what is a SUB ACUTE burn?"

The Sub Acute Stage: From four to 21 days post injury.

 

“Is my loved one in excruciating pain?”

Your loved one will be experience a significant amount of pain throughout treatment. Dressing changes in particular are one of the most painful but necessary steps of the healing process. This technique is essential for proper treatment because it reduces the risk of infection. However, the frequency of which it has to be done and the process itself make it very difficult for the survivor. Fortunately, modern treatment options, like excisions, have reduced the amount of dressing changes necessary.

“What medical complications should we be aware of immediately post-injury?”

There is potential for several medical complications as a result of a major burn injury. Most of these secondary conditions will be checked as soon as a burn victim arrives at the hospital. Although the professionals are expected to recognize and treat the complications, it is important to understand how the body can react immediately after a burn. We have provided you with a list of side effects you should keep in mind while your loved one is being treated.

Respiratory Complications

Breathing will be checked immediately. If there is blockage to the area, which may result from burns in the chest area or inhalation, an endotracheal tube may be inserted to open the airway. If burns around the chest wall are severe, surgery may be necessary. Doctors will perform an escharotomy to remove the damaged tissue. Both treatments ease the pain and difficulty of breathing.

Hypovolemia

Your loved one may lose a large amount of bodily fluids including blood and plasma. If these fluids are not replenished, there is a possibility that the victim will go into shock, and the heart and circulation can be damaged. Fortunately, this is one of the first things checked and treated when a burn victim arrives to the hospital.

Now, you may be wondering what constitutes a fluid resuscitation and how the process works. Patients who have 10% TBSA burned will typically require fluid resuscitation. Half of the fluid lost will be restored within the first eight hours. After the initial resuscitation, the victim will be monitored on an hourly basis according to urine production. The victim’s fluid levels will typically be monitored for 72 hours after the burn.

Hypothermia

Although your first thought may be that the body overheats as a result of a burn, this is not the case. Hypothermia can occur both immediately after a burn and during surgery. Skin is a natural blanket for the body that, in its normal state, holds body heat inside. When a portion of skin is destroyed body heat rushes out and the body’s temperature drops. This is why cold water is not advised as a remedy for a major burn. As tempting as it may be to use it as a means to ease the pain, cold water will only increase the risk of hypothermia.

Tetanus

There is the possibility of contracting tetanus because the bacterium that causes it is resistant of extreme temperatures. A tetanus shot will be administered if a patient has not received one in the past 5 years.

Local infection

Major burn victims can easily contract local infections because the exposed wound is an open invitation for bacteria. To avoid any type of infection, the wound is covered with dressings that protect it from the environment.

What future secondary conditions should we be concerned about?

As you may already know, there are long term secondary conditions that may arise as a result of a major burn injury. The thought of these complications may be daunting at first. However, with awareness, many of these complications can be prevented and/or treated. Below is a list of common long term secondary conditions

• Keloids: A keloid is overgrown scar tissue that extends beyond the wounded area. The scar is raised and is usually flesh colored or pink. Unlike most scars, a keloid does not reduce in size over time. Keloids can lead to limited mobility, but are usually prevented through physical therapy.
  
  
• Hypertrophic Scar: A hypertrophic scar is very similar to a keloid. However, it does not extend beyond the wound and becomes smaller over time.
  
  
• Contracture: Contractures are a consequence of excessive scarring. The formerly elastic tissue in the skin, muscles, tendons and joints are replaced by rigid tissue. As a result, your loved one may experience limited mobility that will be treated with physical therapy.
  
  
• Sepsis: Sepsis is an infection in the bloodstream that is caused by bacteria in the wounded area. If this occurs, your loved one’s blood pressure will drop and he/she can potentially go into shock. Chills, a decrease in urination, rash, lightheadedness, hyperventilation, warm skin, fever and shaking are common symptoms. This illness can be life threatening, so your loved one must be treated immediately.
  
  
• Loss of Sensation: A burn survivor may lose sensation in the wounded area. The amount lost depends on the extent of the burn. Typically, those who lose sensation will have a hard time determining how hot, cold, dull or sharp an object is.
  
  
• Dry Skin: A major burn can permanently destroy sebaceous glands, which produce oil and moisturize skin. To treat this, many burn survivors have to use lotion regularly.
  
  
• Psychological Consequences:A burn accident is a traumatic event and victims are likely to be effected mentally and emotionally. As with any traumatic accident, victims are likely to turn to those they are closest to for support. Family members and friends will play a crucial role in this aspect of the recovery process. Your loved one may be troubled with memories of the accident, physical deformities and the effects the accident has on daily activities. Some common psychological side effects include grief, depression and anxiety. A strong support system and professional help are key throughout this aspect of the recovery process.
  
  

“Will the skin ever look the same?”

Your loved one will, inevitably, have scarring. However, the extent of scarring varies from one survivor to the next. Some may only experience discoloration while others may have permanent disfigurement. ”Emerging technologies are changing the way burn survivors receive treatment for scars. For more information, please visit the Online Surgery.com

“How do we pick a qualified rehabilitation facility?”

Choosing a rehabilitation facility is one of the most important decisions to be made in this entire process. Each rehabilitation facility has varying admission policies and depending on where in the country it is located transportation will need to be secured. These decisions need to be made during the Sub Acute Stage so as soon as the burn injury survivor is medically stabilized they can begin therapy. There are many factors to consider when choosing a rehabilitation facility, but at the very least the facility should meet the criteria set by The American Burn Association and the American College of Surgeons to handle the needs of a burn injury patient. These organizations have set guidelines that a burn center must follow. These regulations are in reference to the following aspects of a burn center:

• • Burn Care Systems
• • Organizational Structure
• • Burn Program
• • Consistency of Protocol and Reporting
• • Admission Levels for the Burn Center
• • Medical Personnel
• • Nursing Personnel
• • Rehabilitation Personnel
• • Other Personnel
• • Performance Improvement Program
• • Other Programs
• • Continuity of Care Program
• • Burn Prevention Program
• • Research Program
• • Configuration of Care Program Program
• • Other Services
• • Operating Suites
• • Emergency Service
• • Allograft Use
  
  

“We don’t have medical insurance, how do we get the care needed?”

The Injury Co-Op has created a comprehensive Benefits resource center to aid you in determining your eligibility for government programs such as:

• • Medicaid
• • Medicare
• • Social Security Income
• • Social Security Disability
• • Food Assistance
• • Welfare
• • Prescription Drug Programs
• • Children’s Benefits
  
  

“What is a support network and why is it important?”

A support network can be family and friends who commit to playing a role in the life of the burn injury survivor and even in the lives of caregivers and immediate family. It also extends to support groups that are often available while in the rehabilitation phase and after discharge. There are also various online support groups that use social media as a tool to discuss and share personal experiences with other survivors. Support groups are important because they provide a strong foundation for burn victims. These groups allow the victims and loved ones to connect to others with a similar background. They also serve as a preparation for what may come in the future. We know the experience can be overwhelming to take in. These support groups offer something for the victim and loved ones to relate to on a personal level.

Support groups are important because they provide a strong foundation for burn victims. These groups allow the victims and loved ones to connect to others with a similar background. They also serve as a preparation for what may come in the future. We know the experience can be overwhelming to take in. These support groups offer something for the victim and loved ones to relate to on a personal level.