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Posted on Dec 28, 2022 in Other subjects

Burns: Classified according to depth and size of the burn.1^stdegree (superficial) & 2^nddegree (partial-thickness/burn top 2 layers). 2-3 weeks healing time.3^rddegree (full-thickness/plus fatty tissue above muscle) & 4^thdegree (skin/fat/muscle/bone), slow healing, produce severe scarring, loss of normal range of motion. Patient’s hand = 1% body coverage.Thermal Burns:most common type of burns caused by fire, hot liquids, or a hot surface. Chemical Burns:direct contact with strong acids, alkaline agents, gases, chemicals. Freeze Injuries:frostbite, proprane. Radiation Burns: large doses cause damage. Electrical Burns:little external damage; causes extensive internal damage; can continue from point of contact; can continue to cause damage after. Inhalation Injury:injury to respiratory tract caused by smoke inhalation and carbon monoxide toxicity. Can lead to brain injury or death.1^st& 2^nd– thermal sources such as hot liquids or radiation (sunburn). 3^rd& 4^th:fire, flame or electrical. Adjustment to burn injuries:85% return to former activities within 6 months; 15% require extensive intermittent reconstructive or cosmetic surgery for a period of about 2 years.Burn recovery: Skin grafts:taken from healthy skin of individual. Skin is recovered from back and legs from cadavers (only top 1.5 layers), donor skin is a temporary dressed. TransCytehuman fiberglass: artificial, temporary skin covering; not rejected by body, mainly for 2nd degree burns; too expensive and has been gone for 15yrs, starting to make a comeback, temperature regulation is difficult (especially with 3rd degree burns b/c thermos is burned away) made by cells from for-skin of babies. RECell: take small graph and scrape cells off tissue, goes into formula, and sprayed on (not the gun).Meshing is a small graph means putting graph through a mesher to slice it like a lettuce plastic wrap with holes in it. Tilapia skin is also being used in other countries (proteins and collagen). Pressure garments:23 hrs/day for 1 year; helps with scarring and mobility. Pain is almost like neuropathic and can last for years. Infections like pseudomonas (past, more deadly) and MRSA (present, less deadly) can be of concern. Stretching skin is important to keep from contractors.Vocational planning for burn injuries: Assess ability to perform past/future jobs, Cosmetic appearance, Pain management, Range of motion. “Big Burn” complete facial burn. Feel isolated, so occupation is beneficial. Functional limitations: Mobility: contractures caused by shortening of tissues or scarring. Lower: walking, climbing, balancing, Upper: reaching, fingering, handling. Cosmetic disfigurement, tolerance to heat, aesthetic appearance, ability to meet the public self-image, trauma to injured skin and/or joints. Prevalence: 80% of adults will experience lbp, More than ¼ of adults reported experiencing in last 3 months. lbp common causes of job-related disability/leading contributor of days missed. 90% of patients experiencing LBP don’t have specific diagnosis:never identify the source. Posture is a big factor. Factors influencing recovery: a high threat meter may not get better with regular PT approaches. Need to reduce threat meter 1^st. Diagnostic approaches: Subjective: pain location, intensity, when it started, any injury. Objective: Strength testing, neurological testing, posture presentation. Diagnoses are short on physical findings, must rely on history/level of reported discomfortTreatment of back pain:strategies to manage symptoms, education. Second choice:manual therapy: joint immobilization, soft tissue mobilization, joint manipulation, modalities(ice, heat, electrical stimulation, traction). Last Resort: surgery, second opinions are encouraged,no benefit to help with chronic low back strain. High Threat Meter:fear of pain, threat meter may need to be turned down first; higher threat meter with concurrent psyc disturbances (especially anxiety and depression). Prognosis: 90% of those experiencing LBP get better in about 3 months, 78% of those with history of LBP have a relapse. Pain is physical and mental present itself physical, may help with chronic pain progression. Sexuality cognitive disabilities: 75% of causes of ID unknown, 25% of all cases are known, 3% US. Pop. have cog disabilities (3 in 100 ppl)Risk Factors:Parent’s age w/conception, Hereditary factors, Environ.factors. 30% of ppl with disabilities have psychological involvement: Depression, Bipolar, PTSD, Obsessive-Compulsive, Aggressive Disorders. 40% of Students: Aggression 58%, Poor Sense of Safety 44%, No Sexual Information 40%, Inapp. Comments 30%, Withdraw into Fantasy 26%, Unusual Fam. Comments 26%, Self-Abuse 26%, Grooming 19%Abuse prevention strategies: Education:Relationship Understanding, Boundary Awareness/Assertiveness, Abuse Awareness and Prevention, Socialization EducationHealthy Self Concept: The Body: how it works, changes, good bad, Exploitation Prevention Relationships: friends vs. friendly, friend vs. intimacy, social boundaries public vs. private, personal space. Social Skills: Privacy need to be taught.ID ppl need to socialize and learn appropriate social skills to elicit/receive. Taught to say yes/compliant. Don’t understand/know how to report abuse. Teach Using:Visual Aides, Role-Modeling, Activities, Opportunities, Community activities. Learn by: Hearing, Talking, Seeing, Example/Non-example, DoingWorkplace considerations: 62.5% of staff who work with people with ID report that consumers have expressed “offensive sexual behavior problems”. Staff report, 83.6% problems addressing these sexual behavior problems.Inappropriate social-sexual behavior has been cited as a primary reason that people with IDLose community employment opportunities. Training for individuals, staff, and the workplace. MANGERS:Can have rude/Poor verba; skills.  ID ppl need to work at real job sites/giveninstruction on behavior, dress, public/private talk, relationships, etc. Co-Workers (what they say about ID):Inappropriate dress, Hygiene Issues, Sex Talk, Whine and complain to anybody, Relationship mishaps, Boundary Issues, Dumpster/Bathroom Dating (Where sexual stuff is happening)Depressive Disorders:Types of mood disorders: Depression, Bipolar (bipolar I, bipolar II, cyclothymia).Bipolar: environmental factors (bipolar is more common in high income than low income countries).