Phases of Burn Therapy
Phases of Burn Therapy
Burn is the destruction of the layers of the skin that could possibly result to the depletion of fluids and electrolytes in the body. It could either be small (body’s response is localized to the injured area only) or large (consist of 25% or more of total body surface area and the body’s response is systemic).
Burn interventions include maintaining airway, fluid resuscitation, and relieving pain, preventing infection, providing optimum nutrition, preventing ulcerations, providing psychological support and preventing contractures. Prompt and timely management of burns would prevent threatening complications particularly in large or extensive burns.
Management of Burn Injury
The phases in the management of a burn injury are the following:
- Emergent phase
This phase begins immediately at the time of injury and ends with the restoration of capillary permeability. The main goal of this phase is to prevent hypovolemic shock and preserve vital organ functioning. Methods used during this time are prehospital care and emergency room care.
- Resuscitative Phase
The management involving resuscitation begins when the fluid replacement are initiated or started and ends when the capillary integrity returns to the near normal levels and when the large fluid shifts have decreased. The amount of fluid administered to the patient is based on the client’s weight and extent of injury. Usually, fluid replacement formulas are calculated from the time of injury not on the arrival on the hospital. The main goal of the resuscitative phase is to prevent shock through the initiation of fluids to maintain adequate circulating blood volume and maintain vital organ perfusion.
- Acute Phase
When the client is hemodynamically stable, has restored capillary permeability and has been showing signs of dieresis, acute phase took place. During this time, the emphasis is palced on restoration of the patient’s capillary permeability and the phase continues until the wound is totally closed. Main goal of the acute phase is focused on prevention of infection, wound care, optimum nutrition and physical therapy.
- Rehabilitative Phase
Rehabilitative phase is the final phase of managing a burn injury. Most frequently, it overlaps the acute phase and it goes on after hospitalization. Main goals during this phase are helping the client gain independence and achieve maximal function.