Care of a severe Burn patient

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Care of a severe Burn patient

Each burn patient, assessment should be started with primary survey(..).The measurement of burn surface area, by using rule of nine method is vital for initial management in order to estimate fluid requirement. Assessment of unburned skin perfusion, can be a tool for circulation status(..).Patients clothing and jewelleries are to be removed for prevention of circulatory blockage(..).

Investigations such as imaging and blood tests including drug and alcohol level,amylase,carboxy haemoglobin are to be performed for optimum treatment plan.Patients serum pottasisum should be monitored closely and to be corrected if required to prevent cardiac arrhythmia.(…).Burn patients, needs complex interdisciplinary therapeutic approach such as dietitian,speech therapist,physio therapist and OTfor optimum management.

Spinal precuations are to be maintained if they have it ,with burns. Close monitoring for rhabdomyolisis and cardiac damage from electrocution injury . Monitor for compartment syndrome at extremities and abdomen are important(..).

Using parkland and modified Brooke formula for fluid management are recommended(…).Ringer lactate is recommended fluid for burn management.The main management is to prevent multiorgan dysfuction.Tetanus vaccine is recommended as prophylaxis.

Inserting urinary indwelling catheter for accurate urine measurement for fluid management and kidney function assessment.Nasogastic tube insertion is important for meeting nutritional needs,administering medication.

Antiemetic ,antidepressants,anxiolytic to be considered for burn treatments.Photograph of burn should be considered prior dressing the wound.acticoat soaked with water normally using for dressing.Management of emotional distress and pain coping strategies are to be considered.Family support as holistic approach.

Antihistamine for pruritis.Blood sugar monitoring and tight control the same are promoting wound healing.Serum albumin level monitoring and replacement is important in management.

Wound swab must be obtained before changing dressing.passive movement,early physiotherapy and splinting and positions to be considered to prevent contracture.

Thoracic manipulative practice: risks and benefits

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  • Thoracic manipulative practice: risks and benefits

In recent years attention has be drawn to the risks, including adverse events of performing orthopaedic manipulative techniques to the spine in physiotherapy practice. As a result the International Federation of Orthopaedic Manipulative Physical Therapist has developed an evidence based framework and consensus document to assist clinicians in reasoning through the relative risk for use in practice. Whilst this is focused to the cervical spine, the reported risk of thoracic manipulative techniques remains a relatively unexplored area. Recent research has reported a range of adverse events following thoracic thrust techniques, including mechanical/vascular injury to the spine, pneumothorax, hamothorax and CSF leakage, albeit in a small numbers. Researchers suggest that that clinicians may not adequately screen for contraindications and precautions prior to undertaking thoracic thrust techniques despite a reported higher incidence of side effects for patients receiving thoracic thrust techniques compared to the cervical spine. With a body of evidence now advocating the use of thoracic thrust techniques over the higher risk cervical manipulative techniques for presentations such as neck pain it is important to consider the safety of such techniques.

Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. If you did not evaluate a patient with this background during the last 8 weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

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Week 8 Assignment 2

Practicum Experience: Journal Entry

Please remember that I am doing my clincals at a nursing home where the patients are 50-88 in age.

After completing this week’s Practicum Experience, reflect on a patient with a known history of a renal disorder. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care. If you did not evaluate a patient with this background during the last 8 weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

Decide how many cost centers should be used for the above expenses at the Rehabilitation and Wellness Center. 2. Set up a worksheet with individual columns across the top for the cost centers you have chosen. 3. For each of the expenses listed above, indicate to which of your cost centers it should be assigned.

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CHAPTER 5

Example 5A: Grouping Expenses by Cost Center

Cost centers are one method of grouping expenses. For example, a nursing home may consider the Admitting department as a cost center. In that case the expenses grouped under the Admitting department cost center may include:463464 • Administrative and Clerical Salaries • Admitting Supplies • Dues • Periodicals and Books • Employee Education • Purchased Maintenance

Practice Exercise 5–I: Grouping Expenses by Cost Center

The Metropolis Health System groups expenses for the Intensive Care Unit into its own cost center. Laboratory expenses and Laundry expenses are likewise grouped into their own cost centers.

Required

  1. Set up a worksheet with individual columns across the top for the three cost centers: Intensive Care Unit, Laboratory, and Laundry. 2. Indicate the appropriate cost center for each of the following expenses: • Drugs Requisitioned • Pathology Supplies • Detergents and Bleach • Nursing Salaries • Clerical Salaries • Uniforms (for Laundry Aides) • Repairs (parts for microscopes) (Hint: One of the expenses will apply to more than one cost center.)

Headings for your worksheet:

Intensive Care Unit Laboratory Laundry

Assignment Exercise 5–1: Grouping Expenses by Cost Center

The Metropolis Health System’s Rehabilitation and Wellness Center offers outpatient therapy and return-to-work services plus cardiac and pulmonary rehabilitation to get people back to a normal way of living. The Rehabilitation and Wellness Center expenses include the following:• Nursing Salaries • Physical Therapist Salaries • Occupational Therapist Salaries • Cardiac Rehab Salaries • Pulmonary Rehab Salaries • Patient Education Coordinator Salary • Nursing Supplies • Physical Therapist Supplies • Occupational Therapist Supplies • Cardiac Rehab Supplies 464465 • Pulmonary Rehab Supplies • Training Supplies • Clerical Office Supplies • Employee Education

Required

  1. Decide how many cost centers should be used for the above expenses at the Rehabilitation and Wellness Center. 2. Set up a worksheet with individual columns across the top for the cost centers you have chosen. 3. For each of the expenses listed above, indicate to which of your cost centers it should be assigned.