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Positioning Approach for Burned Patients

عن النعمان بن بشير ,قال: قال رسول اللة صلى اللة علية وسلم : ” ترى المؤمنين فى تراحمهم , وتوادهم, وتعا طفهم، كمثل الجسد ,ا ذا اشتكى عضوا, تداعى لة سائر جسدة بالسهر و الحمى“ اخرجة البخارىفى –78كتاب الأدب. Positioning Approach for Burned Patients. Positioning Approach for Burned Patients.

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Positioning Approach for Burned Patients

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  1. عن النعمان بن بشير ,قال: قال رسول اللة صلى اللة علية وسلم : ” ترى المؤمنين فى تراحمهم , وتوادهم, وتعا طفهم، كمثل الجسد ,ا ذا اشتكى عضوا, تداعى لة سائر جسدة بالسهر و الحمى“ اخرجة البخارىفى –78كتاب الأدب

  2. Positioning Approach for Burned Patients

  3. Positioning Approach for Burned Patients Definition (s) of positioning. Objectives of positioning program . Indications for positioning of burned patients . Basic and general concepts for positioning program. Specific consideration in positioning program. Procedures of positioning of different areas and techniques of application. Education and communication for teaching positioning program .

  4. Positioning is awareness of relation of different body parts to each other and in relation to space. • Proper positioning can be defined as proper arrangement of different body parts, that was necessary for successful burn patients rehabilitation.

  5. Goals (Objectives) of positioning • To minimize & control post burn edema . • To facilitate good wound healing care and prevent contracture. • To prevent soft tissue destruction & maintain it in an elongate state. • To maintain function ROM . • To prevent localized Neurological and neuropathies deficit. • To facilitate function recovery. N.B(1-5 STO) & (6-LTO)

  6. Indications for Positioning Burned Patients • Loss of consciousness & ventilatory dependent patients. • Patient's who is unable or unwilling to cooperate to exercises program. • Children have difficulty to understand exercises procedures. • Immediate post-grafting and reconstructive procedures. • Complications may impose limitation or contractures.

  7. General and Basic Principle for Positioning of Burned patients • Good and proper positioning program is effective for immobile and active patients. • Burn will induce losses of motion, contracture, and scar, according to location, extent, depth, pain, prolonged period of immobility, delayed and improper physical and occupational therapy. • Daily monitoring of the patients medical status , ROM, and skin conditions will assist the therapists in deciding how long positions are to be maintained and necessary modifications. • Positioning program must be individualized to the patients need and should be modified throughout hospitalization. • The basic role for positioning burned area is place and maintain the affected part in the opposite plan and direction to which it will potentially contract.

  8. Specific Consideration in Positioning Burned Patients • Positioning program for post burn edema reduction . -Head and Neck edema . -Extremities Edema. • Positioning following reconstructive surgery -Skin graft -Reconstructive procedure for head &neck -Ankle planter flexion contracture -Burn –Acquired deformities

  9. Teaching and communication program for positioning • Burn team members who should b involved in burned care, positioning program • Physicians. • Physical therapist. • Nursing staff. • Caregivers • Family members

  10. Method for Teaching and communication for positioning program • Simple positioning diagram at bed side. • Comprehensive positioning chart. • Writing in medical record. • Photographing the correct position • Plastic slider holder to display diagrams • Video display • Direct patient and staff education during round. • Batty stickers with pictures

  11. This is second degree contact burns to a hand

  12. This is second and third degree contact burns to a hand

  13. . • Second Degree Hand Burn

  14. . • Second Degree Hand Burn

  15. I-Explained the Following Statements:- • A-Deep dermal burn sustained greater loss of motion and contracture than with superficial dermal burn, and put difficulties during positioning program. • B-Daily monitoring of medical status, ROM, , and Skin conditions help therapists in deciding how long position and necessary modification during rehabilitation process. • C- Location , extent and associated pain will affect capacity to move and positioning program.

  16. II-Put (T) in front of correct sentence & (F) in front of false one:- • 1-Positioning program must focus on edema reduction rather than maintaining anti-contracture during acute phase. • 2-Edema of head and neck causing upper airy way obstructions. • 3-Positioning & splinting must be delayed during emergency phase until statistic edema formation. • 4-In asymmetrical neck burn ,use of environmental stimuli encourage correction of faulty position • 5-The use of donut is recommended in case of head &neck burn

  17. 6-Elevation and positioning should maintain even while patient isambulating . • 7-Positioning program must be individualized and modified to the patients need. • 8-Patients with the acceptable ROM and good skin condition require positioning for 24 hours. • 9-Asymmetrical trunk burn will induce scoliosis with concavity opposite to burn site. • 10-Lateral neck burn will induce tertecollis for children.

  18. III-Complete the Following Statements:- A-Peroneal neuropathy may occur secondary to; • 1-……………………………………………………………………... • 2-……………………………………………………………………... • 3-……………………………………………………………………... • 4-……………………………………………………………………... B-Indication for positioning program include • 1-……………………………………………………………………... • 2-……………………………………………………………………... • 3-……………………………………………………………………... • 4-……………………………………………………………………... C-Improper position of upper extremity with complete extension of elbow predispose to …………………………&………………………… D- The objective of positioning program following reconstructive phase are • 1-……………………………………………………………………... • 2-……………………………………………………………………... • 3-……………………………………………………………………... E-Halo neck splint can be used following neck contracture release to keep child ………………………………………………………………… F- To correct planter flexion contracture therapist can use .................. • ……………………………………………………………………………..

  19. III-Complete the Following Statements:- G- Skeletal suspension can be used to ………………………………….. • ………………………………………...&………………………………… H-Positioning of head and neck in extension should be delayed until maintaining of ………………………………………………………….... I-Methods of teaching positioning program include • 1-……………………………………………………………………... • 2-……………………………………………………………………... • 3-……………………………………………………………………... • 4-……………………………………………………………………... J-The neuropathic deficit may occur secondary to • 1-……………………………………………………………………... • 2-……………………………………………………………………... • 3-………………………………………………………… K- Brachial plexus neuropathy may results from • 1-……………………………………………………………………... • 2-……………………………………………………………………... • 3-……………………………………………………………………... • 4-……………………………………………………………………...

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