Psychosocial Considerations for a Patient with Burn Injuries Case Discussion: Difference between revisions

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=== Patient's Present and Past Medical History ===
=== Patient's Present and Past Medical History ===
Oleksandr is a 40-year-old male involved in a house fire two days ago. He sustained 55% TBSA (Total Body Surface Area) burns to his face, chest, right upper extremity (RUE) and right lower extremity (RLE).  His burns are a mix of superficial, partial and full thickness. He also has findings of soot around his nares and mouth. Oleksandr was initially treated at his local hospital and then transferred to a regional burn centre that is 100 kilometres from his home.  
Oleksandr is a 40-year-old male who sustained 55% TBSA (Total Body Surface Area) burns to his face, chest, right upper extremity (RUE) and right lower extremity (RLE) in a house fire two days ago. His burns are a mix of superficial, partial and full thickness. He also has additional findings of soot around his nares and mouth. Oleksandr was initially treated at his local hospital and then transferred to a regional burn centre that is 100 kilometres from his home.  


Oleksander's past medical history includes type II diabetes, which is currently well controlled, depression and daily tobacco use. The patient smoked one pack of cigarettes a day.
Oleksander's past medical history includes type II diabetes, which is currently well controlled, depression and daily tobacco use, smoking one pack of cigarettes per day.


=== Social History ===
=== Social History ===
Olekasander lives with his wife and 2 children, who were not home during the fire and are living out of the country. He works as an electrician. His house was destroyed in the fire and is no longer inhabitable. His brother lives 100 kilometres from the regional burn centre but stays with Oleksandr in the hospital.  
Olekasander normally lives with his wife and two children. However, his family were not home during the fire as they are currently living out of the country. Olekasander works as an electrician. His house was destroyed in the fire and is no longer inhabitable. His brother lives 100 kilometres from the regional burn centre but is currently staying with Oleksandr in the hospital.  


== Family Involvement in Patient's Care ==
== Family Involvement in the Patient's Care ==
Part of Oleksandr's sessions within the hospital included the physical therapist showing his brother Oleksandr's stretching program and how to assist Oleksandr with his basic mobility tasks such as getting in and out of bed, going from sitting to standing, and walking with the walker. Once a week, a Facetime session with his family, including his children, was incorporated into a therapy session so that Oleksandr could show them what he was doing in his sessions and he could have support and encouragement from them.  
During Oleksandr's physical therapy sessions in the hospital, the physical therapist is able to show Oleksandr's brother his stretching programme and how to assist Oleksandr with basic mobility tasks, such as getting in and out of bed, transferring from sitting to standing, and walking with a walker. Once a week, A Facetime call with Oleksandr's family, including his children, is incorporated into a therapy session, so that Oleksandr can show them what he was doing in his sessions. These sessions also mean that Oleksandr can receive support and encouragement from his family.  


Since his family was out of the country, they had limited psychological support outside of the friends they were living with and the support they received from the rehabilitation team. During therapy sessions, the physical therapist was able to provide basic psychological first aid to his family. Oleksandr had access to a psychologist weekly, and as needed, the psychologist would sometimes be present during difficult physical therapy sessions to help provide psychological support for Oleksandr.  
Since Oleksandr's family is currently out of the country, they have limited access to psychological support outside of the friends they are living with and the support they receive from the rehabilitation team. During therapy sessions, the physical therapist is able to provide basic psychological first aid to his family.  
 
Oleksandr has access to a psychologist weekly. The psychologist can also sometimes be present during difficult physical therapy sessions to help provide psychological support for Oleksandr.  


== Discharge Considerations ==
== Discharge Considerations ==
Oleksandr was discharged to his brother's home. His brother was able to have community members modify the home to have an accessible entrance with a ramp and create a first-floor set-up for Oleksandr to live in to make navigating his environment easy for him.  
When Oleksandr is ready for discharged, he is discharged to his brother's home. Community members have helped modify his brother's home, so it now has an accessible entrance with a ramp and a first-floor set-up for Oleksandr to live in. This has made it easy for Oleksandr to navigate his environment.  


== Caregiver Training ==
== Caregiver Training ==
Oleksandr's brother was his primary caregiver. Before leaving the hospital, Oleksandr's brother was provided caregiver training on the following:  
Oleksandr's brother is now Oleksandr's primary caregiver. Before leaving the hospital, Oleksandr's brother was provided caregiver training on the following:  


* providing physical assistance for all basic mobility tasks  and activities of daily living  
* providing physical assistance for all basic mobility tasks  and activities of daily living  
* basic wound care including changing dressings and wrapping with compression where appropriate
* basic wound care including changing dressings and wrapping with compression where appropriate
* how to assist Oleksandr with his stretching program
* how to assist Oleksandr with his stretching programme
* signs and symptoms of infection and other indications to return to the hospital
* signs and symptoms of infection and other indications to return to the hospital



Revision as of 04:26, 17 May 2024

Original Editor - Lilly Webster

Top Contributors - Ewa Jaraczewska and Jess Bell  

Patient Presentation[edit | edit source]

Patient's Present and Past Medical History[edit | edit source]

Oleksandr is a 40-year-old male who sustained 55% TBSA (Total Body Surface Area) burns to his face, chest, right upper extremity (RUE) and right lower extremity (RLE) in a house fire two days ago. His burns are a mix of superficial, partial and full thickness. He also has additional findings of soot around his nares and mouth. Oleksandr was initially treated at his local hospital and then transferred to a regional burn centre that is 100 kilometres from his home.

Oleksander's past medical history includes type II diabetes, which is currently well controlled, depression and daily tobacco use, smoking one pack of cigarettes per day.

Social History[edit | edit source]

Olekasander normally lives with his wife and two children. However, his family were not home during the fire as they are currently living out of the country. Olekasander works as an electrician. His house was destroyed in the fire and is no longer inhabitable. His brother lives 100 kilometres from the regional burn centre but is currently staying with Oleksandr in the hospital.

Family Involvement in the Patient's Care[edit | edit source]

During Oleksandr's physical therapy sessions in the hospital, the physical therapist is able to show Oleksandr's brother his stretching programme and how to assist Oleksandr with basic mobility tasks, such as getting in and out of bed, transferring from sitting to standing, and walking with a walker. Once a week, A Facetime call with Oleksandr's family, including his children, is incorporated into a therapy session, so that Oleksandr can show them what he was doing in his sessions. These sessions also mean that Oleksandr can receive support and encouragement from his family.  

Since Oleksandr's family is currently out of the country, they have limited access to psychological support outside of the friends they are living with and the support they receive from the rehabilitation team. During therapy sessions, the physical therapist is able to provide basic psychological first aid to his family.

Oleksandr has access to a psychologist weekly. The psychologist can also sometimes be present during difficult physical therapy sessions to help provide psychological support for Oleksandr.

Discharge Considerations[edit | edit source]

When Oleksandr is ready for discharged, he is discharged to his brother's home. Community members have helped modify his brother's home, so it now has an accessible entrance with a ramp and a first-floor set-up for Oleksandr to live in. This has made it easy for Oleksandr to navigate his environment.

Caregiver Training[edit | edit source]

Oleksandr's brother is now Oleksandr's primary caregiver. Before leaving the hospital, Oleksandr's brother was provided caregiver training on the following:

  • providing physical assistance for all basic mobility tasks  and activities of daily living
  • basic wound care including changing dressings and wrapping with compression where appropriate
  • how to assist Oleksandr with his stretching programme
  • signs and symptoms of infection and other indications to return to the hospital

From a physical therapy perspective, the highest priority for caregiver training was how to assist Oleksandr with his basic mobility to continue to make functional gains and improve his independence with mobility and activities of daily living.

Resources[edit | edit source]