Burns are injuries to the skin or other bodily tissues caused by heat, chemicals, electricity, or radiation. Burns are described based on surface area and depth. They are typically classified as either superficial thickness, superficial partial thickness, deep partial thickness, or full thickness burns.
Symptoms
Physical
- Scars / open wounds
- Contractures
- Shock
- Eschar
- Pain
- Muscle weakness
- Decreased range of motion
- Edema
- Infection
- Decreased sensation, peripheral neuropathy
Cognitive
Affective
- Depression
- Anxiety
Assessments
Physical
- Rule of 9’s
- Lund and Browder Scale
- Rang of motion
- Brief Pain Inventory
- Visual analogue pain scale
- Burn Scar Index / Vancouver Scar Scale
Cognitive
Affective
- Beck’s Depression Inventory
- Beck’s Anxiety Inventory
Function
- Canadian Occupational Performance Measure (COPM)
Common Occupational Performance Issues (OPIs)
Self-Care
- Difficulty sleeping due to pain
- Decreased functional mobility due to pain, contractures, decreased range of motion, muscle weakness
- Difficulty dressing, grooming, bathing, feeding, and toileting due to pain, decreased motivation, and decreased functional mobility
- Risk for further skin damage due to changes in sensation
Productivity
- Difficulty with community mobility
- Absenteeism, presenteeism, decreased work performance due to anxiety about body appearance
- Difficulty with shopping, home maintenance, meal preparation, and caring for others due to pain, decreased functional mobility, anxiety and depression
Leisure
- Social isolation due to anxiety and depression
- Decreased occupational engagement
Frames of Reference
- Biomechanical
- Cognitive Behavioural
Interventions
Self-Care
Education: education regarding wound care, infection prevention, wound management, edema control, compensatory strategies for sensory loss, orthotic care
Wound Care: scar massage, pressure garments, silicone pads, orthotics for contractures, edema management, range of motion and strengthening exercises, desensitization
Pain, Anxiety, Depression: Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), Motivational Interviewing (MI), support groups, pain journals
ADLs: energy conservation, assistive devices, education for safe and proper use of assistive devices, task modification and simplification
Productivity
Community Integration: assistive devices for mobility and required education, public transportation, gradual community exposure
Work / School: job demands analysis (JDA), functional mobility evaluation (FAE), advocate to employer for necessary accommodations or modifications, assertiveness training for client to help manage difficult social situations
Home: energy conservation strategies for IADLs, assistive devices for IADLs and necessary education, assertiveness training to help manage home and caregiver tasks, task simplification and modification
Leisure
Leisure Exploration: support groups, meaningful occupation
Leisure Participation: gradual exposure, task simplification and modification