LIVING WITH A BURN TRAUMA

Page 2

BURN TREATMENTS

ABOUT BURNS

When a victim/survivor reaches a trauma unit, the medical team works to stabilize the body's vital functions. The team assesses the injured for shock and respiratory failure. Fluid replacement may be required if large amounts have been lost. Depending upon the severity of the burns, intravenous feeding and mechanical assistance to breathe may also be necessary. Burns
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are cleaned once or twice daily and then dressed with medicated creams. This cleansing with antiseptic solutions is called debridement. Debridement is necessary to remove dead skin, old cream residues, and secretions from the skin.

As skin protects the body from contamination it is easy to understand that there is serious risk of infection. This risk remains until the burns heal or are completely grafted. Because a burn victim/survivor's health is compromised, there is legitimate and ongoing concern, even when it seems their health status is improving.

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Along with infection, doctors and other medical personnel carefully monitor and treat pain. Burns
themselves can be very painful as well as the regimens required to treat them. Pain medications, anti-anxiety medications, and relaxation techniques are often utilized to address pain issues. Some medications interfere with organ functions so doctors dose accordingly.

Skin grafting is the next crucial step in treatment for some second degree burns and all third degree burns. First the injured tissue is surgically removed if the destroyed skin does not separate naturally. Then a section of healthy, unburned skin (referred to as the donor area) is removed and attached to the area destroyed by the burn (referred to as the recipient area). Before this can be done, the area must be prepared to receive the donor skin.

At times skin donated from other people, called homograft, allograft, or cadaver skin is used. This skin donated from other sources is temporary and used when donor skin is scarce. Depending upon the extent of the injury, some victims/survivors require multiple surgeries. The area of a graft is not moved for up to five days following surgery in order for the graft to become secure. Then exercise programs, tub baths, and other activities resume. Exercise helps manage swelling, helps the burn to heal, and promotes range of motion when contraction occurs.

THE BURN UNIT EXPERIENCE

The Burn Trauma Victim/Survivor: Burn victims/survivors are often heavily sedated or are in shock when they reach the burn unit, and may have little knowledge of the gravity of their circumstances. The first several days or weeks can be hazy. Victims/survivors are quickly introduced to grueling treatment regimens with little time to think or feel. Later, after interacting with family, friends, and medical personnel, they are able to develop a sense of their condition and may begin to fear what will happen to them. They may even fear that they will die as a result of their injuries. As a burn trauma victim/survivor, you may recall spending the initial days and months after a burn injury fearing the unknown and the uncertainty of the future. You may remember being fearful of both physical and emotional pain. You may have wondered what would happen to your family, what pain and suffering they might experience as a result of your injury. Some burn victims/survivors rely heavily upon burn unit staff to meet their physical and emotional needs as not to burden their families. Because of the nature of the injuries and the treatments of burns, the hospital becomes a comfortable, protective, and insulated environment that is difficult to leave.

The Family Member and Friend Victim/Survivor

While the injured victim/survivor may be heavily sedated for some time after the crash, family and friends are acutely aware of the gravity of the situation. When you learned of your loved one's crash and subsequent injuries, your initial reactions may have included shock, despair, and fear that your loved one might die from the burn injury. Because many burns appear painful and horrific, you may have been fearful of how your loved one would suffer. You may still be fearful.

Depending upon the severity of the burn injury you may feel anxious,

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depressed, guilty, and worried when thinking about your future and the future of your loved one. Anger may follow after learning of the consequences of the burn. Receiving good and reliable information can be difficult. Nonetheless, a victim/survivor's adjustment is heavily dependent upon the love and support you offer them. If the victim/survivor has a child or children, they may be separated from them for long periods of time. Keep in mind that if the burns have caused any kind of disfigurement, children might not recognize their parent or they may be fearful of their parent's appearance. They may have been instructed by other adults not to touch the victim/survivor because touch can be painful. Children also might be fearful and anxious about their parent's ability to care for them. As an adult caregiver it is important to provide children love and support as well as ongoing information that is accurate and age appropriate.

GOING HOME

The length of stay in burn units has decreased over the years yet burn victims/survivors may be reluctant to go home. Many people feel anxious about leaving the safe and insulated environment provided by the hospital and its staff. For the injured victim/survivor of a drunk driving crash, going home also means facing the difficulties associated with the crash. The reality of disfigurement or disability may not hit until arriving home. Victims/survivors maybe confronted with altered appearances, altered selfimages, physical impairments, and psychological reactions, all of which can be scary. Many people derive self-esteem and self-image from their physical appearance, particularly women, who are raised to place focus on their looks. As a burn victim/survivor, you may not look as you did before the crash. You may not be able to operate in the same capacity you once did. When you first return home it may be difficult for you to fulfill your roles as wife, mother, husband, or father due to physical impairments.

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