VR for adjunctive analgesia during burn wound care and physical therapy

1999 ◽  
Author(s):  
Hunter G. Hoffman ◽  
David R. Patterson ◽  
Gretchen J. Carrougher ◽  
Thomas A. Furness
Keyword(s):  
Physical Therapy ◽  
Wound Care ◽  
Burn Wound

577 The Collaboration of Burn Outreach and Wound Care Nurses

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S140-S140
Author(s):  
Ekta Vohra
Keyword(s):  
Wound Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospital Setting ◽  
Basic Knowledge ◽  
Definitive Treatment ◽  
Knowledge Gap ◽  
Burn Wound ◽  
Improvement Project ◽  
Burn Wounds

Abstract Introduction Certified wound care nurses perform a vital role in skin health and management in the hospital setting. During the certification process, minimal time is spent on burn wound education, despite the fact that wound care nurses are consulted for various wound etiologies; one of those being burns. This construct created a need for collaboration between the burn team and wound care nurses. Although all burns are essentially wounds, the reality is that all wounds are not burns. The management of the burn wound is often different from the management of pressure injuries or surgical wounds. In speaking with the wound care nurses at this large urban academic medical center, a knowledge gap was identified in burn wound care education as well as appropriate and timely consultation of the burn team. Methods This knowledge improvement project focused on educating the wound care nurses in assessment and treatment of burns, and the process for burn service consultation. Burn education was provided through in-person didactic presentations. The lecture included burn wound photos with opportunities to classify the potential depth of burn wounds as well as typical complications. Additionally, it discussed when a burn consult is needed. A basic knowledge retrospective pre-posttest method was utilized. Results An educational plan was tailored to meet the learning needs of the wound care nurses to address the knowledge gap. Post test data results were tracked. Post scores were increased, indicating a successful educational intervention. Also, while providing the education, the burn outreach coordinator identified an opportunity to expand the burn center’s presence among colleagues through collaboration with the wound care nurses. The wound nurses made excellent ambassadors for the mission of the burn service. Conclusions Provision of burn education across disciplines may improve recognition of burn wounds and facilitate definitive treatment.

Recent trends on burn wound care: hydrogel dressings and scaffolds

2021 ◽  
Author(s):  
Yingxia Yao ◽  
Andi Zhang ◽  
Congshan Yuan ◽  
Xiguang Chen ◽  
Ya Liu
Keyword(s):  
Wound Care ◽  
Burn Wound ◽  
Recent Trends

Biomaterial -based therapy in burn wound care and the roles and advantages of hydrogels.

scholarly journals Virtual Reality Analgesia for Children With Large Severe Burn Wounds During Burn Wound Debridement

2020 ◽  
Vol 1 ◽  
Author(s):  
Hunter G. Hoffman ◽  
David R. Patterson ◽  
Robert A. Rodriguez ◽  
Raquel Peña ◽  
Wanda Beck ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Pain Intensity ◽  
Wound Care ◽  
Primary Outcome Measure ◽  
Control Group ◽  
Severe Burn ◽  
Burn Wound ◽  
Absolute Change ◽  
Wound Debridement ◽  
Pain Medications

The objective of this study was to compare the effect of adjunctive virtual reality vs. standard analgesic pain medications during burn wound cleaning/debridement. Participants were predominantly Hispanic children aged 6–17 years of age, with large severe burn injuries (TBSA = 44%) reporting moderate or higher baseline pain during burn wound care. Using a randomized between-groups design, participants were randomly assigned to one of two groups, (a) the Control Group = pain medications only or (b) the VR Group = pain medications + virtual reality. A total of 50 children (88% Hispanic) with large severe burns (mean TBSA > 10%) received severe burn wound cleaning sessions. For the primary outcome measure of worst pain (intensity) on Study Day 1, using a between groups ANOVA, burn injured children in the group that received virtual reality during wound care showed significantly less pain intensity than the No VR control group, [mean worst pain ratings for the No VR group = 7.46 (SD = 2.93) vs. 5.54 (SD = 3.56), F(1,48) = 4.29, < 0.05, MSE = 46.00]. Similarly, one of the secondary pain measures, “lowest pain during wound care” was significantly lower in the VR group, No VR = 4.29 (SD = 3.75) vs. 1.68 (2.04) for the VR group, F(1,47) = 9.29, <0.005, MSE = 83.52 for Study Day 1. The other secondary pain measures showed the predicted pattern on Study Day 1, but were non-significant. Regarding whether VR reduced pain beyond Study Day 1, absolute change in pain intensity (analgesia = baseline pain minus the mean of the worst pain scores on Study days 1–10) was significantly greater for the VR group, F(1,48) = 4.88, p < 0.05, MSE = 34.26, partial eta squared = 0.09, but contrary to predictions, absolute change scores were non-significant for all secondary measures.

A randomized controlled trial of hypnosis for burn wound care.

2007 ◽  
Vol 52 (3) ◽  
pp. 247-253 ◽  
Author(s):  
Shelley Wiechman Askay ◽  
David R. Patterson ◽  
Mark P. Jensen ◽  
Samuel R. Sharar
Keyword(s):  
Randomized Controlled Trial ◽  
Wound Care ◽  
Controlled Trial ◽  
Burn Wound ◽  
Randomized Controlled

Burn Wound Care

2011 ◽  
pp. 71-71
Author(s):  
Prema Dhanraj
Keyword(s):  
Wound Care ◽  
Burn Wound

36 Developing Burn Specific Documents in the Electronic Medical Record

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S25-S25
Author(s):  
Kari Gabehart ◽  
Sara Tuvell ◽  
Christina L Cook ◽  
David Roggy ◽  
Rajiv Sood
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Fluid Resuscitation ◽  
Wound Care ◽  
Burn Wound ◽  
Monthly Basis ◽  
Team Members ◽  
Handheld Device ◽  
Burn Care ◽  
High Level

Abstract Introduction The challenge with burn documentation needs in electronic medical record systems is recognized and often limited in the foundation of commercial electronic systems. In October 2016, our institution transitioned to a new all-inclusive electronic medical record. The transition to this new Electronic Medical Record (EMR) afforded us the opportunity to develop and build burn specific documentation needs in the new EMR system. In this paper, we share our experiences and the keys to our successful builds to streamline burn patients’ documentation and information. Methods In January 2013, the EMR build team was composed of corporate contractors, dedicated clinical staff from all areas of the hospital that transitioned to the build team, and private contractors experienced in the EMR build process. To our great fortune, our burn team was provided access to four dedicated build team members that worked specifically on meeting our burn team documentation needs. With high level collaboration our team was able to assess foundation abilities of the new system, identify gaps to burn care and collaboratively create and build automated documents to meet our burn needs. In October 2016, the EMR system was implemented with our burn specific documents, flowsheets, and reports. Results Through working with our dedicated build team, we were able to create an electronic Lund-Browder Chart with an avatar that is completed with each admission by our medical team. We developed a fluid resuscitation flowsheet that is documented in real-time; displays fluid resuscitation goals; displays urine output goals. The creation of a standardized wound care note template was necessary as the wound template within the existing EMR system was too cumbersome. Burn wound photo-documentation to include inpatient, outpatient, intra-operative and emergency department needs automatically uploads into the patient’s medical record from an encrypted portable handheld device connected to the EMR. Burn specific reports were developed to meet the specific needs of inquiry whether it is for performance improvement or research. Additionally, the same EMR is used in all phases of care to include the burn clinic which allows for ease and continuity of care. Conclusions An EMR that is all-inclusive has benefitted our team and patient safety by streamlining the review and documentation of information. Having specific and dedicated EMR build specialist allocated to focusing on the needs of the burn unit was invaluable in the build, implementation, and maintenance phases. We continue to work with our EMR specialist to improve processes and documentation practices that impact patient outcomes. Our burn EMR specialist meets with the burn team on a monthly basis to evaluate and assess ongoing needs to further outcomes. Applicability of Research to Practice Within this presentation, we will share our journey, challenges, and successes.

726 The Use of Xeroform Dressings for Partial Thickness Scald Burn Injuries in a Verified Pediatric Burn Center

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S194-S195
Author(s):  
Lisa C Vitale ◽  
Jennifer Livingston ◽  
Erica Curtis ◽  
Katherine Oag ◽  
Christina M Shanti ◽  
...  
Keyword(s):  
Burn Injury ◽  
Wound Care ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Wound Complications ◽  
Burn Wound ◽  
Burn Center ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
At Home

Abstract Introduction For children who have suffered a burn injury one of the greatest challenges is managing pain with an adequate yet practical burn wound dressing that will ultimately be managed at home. Medical product companies have created a variety of wound care products available on the market. These products are advertised to be more superior over one another in categories such as decrease in wound infections, minimization of pain, ease of dressing application, increased dressing wear time, and better wound healing. With all the options for burn wound care there are many factors to consider when choosing a burn dressing such as cost, ease of dressing for families at home, comfort, and efficacy. At our ten year verified pediatric burn center we have tried many different burn wound care products, however we have found Xeroform and bacitracin to be the most practical and easy to use for our patient population. Methods A retrospective chart review was performed from 2016–2018 of all cascading scald injuries to children 0–5 years of age treated at our verified pediatric burn center. 179 patients were included in this review. Of those patients a total of 52 patients were excluded, 28 patients had no follow up, 21 patients received alternate dressings, and 3 patients had full thickness injuries requiring a split thickness skin graft (STSG). Charts were reviewed for total body surface area (TBSA), length of stay (LOS), discharge dressing type, complications, and time to healing. All patients included routinely received consistent application of the Xeroform and bacitracin. Results 127 patients discharged with Xeroform dressings were included in this study with an average age of 1.4 years old (range 0–5 years) and average TBSA of 2.5% (range 0.25–13%). The average LOS was 1.6 days (range 1–10 days). In this sample 32 (25%) patients were healed within 7 days. 77 (61%) patients were healed within 7–14 days. 11 (9%) patients were healed within 14–21 days. 7 (5%) patients were healed in greater than 21 days. There were no wound complications identified within this study group. Conclusions Using Xeroform as our standard of practice has streamlined the care provided to our patients. We have demonstrated consistent effective re-epithelization, protection from infection, and ease of dressings for families and burn providers. In our experience Xeroform has provided a versatile way to care for partial thickness burn injuries. Applicability of Research to Practice We suggest Xeroform and bacitracin dressings be used for partial thickness burn injuries in patients under 5 years of age. This dressing may be superior to other products because it allows for bathing while providing good wound epithelization and is easy to use.

How Is Wound Care and Integumentary Education Being Taught in Professional-Level Physical Therapy Programs?

2019 ◽  
Vol 10 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Daryl Lawson ◽  
Heather Hettrick ◽  
Srikant Vallabhajosula ◽  
James Matthew Hale
Keyword(s):  
Physical Therapy ◽  
Wound Care ◽  
Physical Therapy Programs

Presentation and Management of Staphylococcal Scalded Skin Syndrome in a Child After a Burn Injury: A Case Report

2019 ◽  
Author(s):  
Thomas Edward Pidgeon ◽  
Federica D’Asta ◽  
Malobi Ogboli ◽  
Yvonne Wilson
Keyword(s):  
Case Report ◽  
Burn Injury ◽  
Wound Care ◽  
Total Body Surface Area ◽  
Granular Cell ◽  
Burn Wound ◽  
Staphylococcal Scalded Skin Syndrome ◽  
The Face ◽  
Total Body ◽  
Learning Points

Abstract This case report describes the clinical course of a child who developed staphylococcal scalded skin syndrome (SSSS) after a burn injury. The intent is to aid other units in recognizing the presentation of SSSS after a pediatric burn and to optimize subsequent management. The main clinical finding was of rapid, progressive, superficial epidermal loss at sites separate from the original burn, involving 55% of the total body surface area, 13 days after a 6% scald burn to the face, neck, and chest. Diagnosis was confirmed by multidisciplinary team clinical assessment and histopathology of an intraoperative skin biopsy. This confirmed epidermal cleavage at the granular cell layer. These findings were later supported by Staphylococcus aureus cultured from the burn wound, and a positive epidermolytic toxin A assay. Management was with general medical supportive care, clindamycin and flucloxacillin intravenous antibiotic therapy, and cleansing and dressing of the areas of epidermal loss. Key learning points from this case were that SSSS presented after a burn injury and that 13 days elapsed between the burn and SSSS. Factors differentiating it from toxic epidermal necrolysis are described, including the value of histopathology in confirming the diagnosis. The prompt use of antibiotics and attentive wound care are advocated as an effective management strategy.

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