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From Rescue To Recovery

Ots In The Country's Top Burn Centers


A fire moves fast and swift, bringing destruction to people and their homes. So when pediatric patients arrive at a burn center, medical teams move with the same swiftness to save lives and help put young fire victims on the road to recovery sooner.

The American Burn Association estimates 500,000 people are treated for burns in the U.S. each year. The number represents the range of burn injuries — from mild burns treated in doctors’ offices to those severe cases admitted to one of the country’s 125 hospitals with specialized burn units. For those admitted to a burn center, there is a 95% survival rate, thanks in large part to the early intervention protocols of multidisciplinary teams, in which OTs play a crucial role.

“From the moment a burn patient hits the doors of our center, an OT evaluates them within the first 24 hours of their stay,” says Mark Prochazka, MOTR/L, part of a staff of OTs dedicated to the North Carolina Jaycee Burn Center in Chapel Hill.

Advancing Treatment Technology

Once splints are in place, OTs turn their focus to supporting a patient’s mobility. As early as the ICU, OTs can begin working on simple things such as positioning, massage, and early range of motion activities, all of which are critical during active scarring phases.

At St. Louis Children’s Hospital in Missouri, staff members have perfected a protocol that includes the use of conscious sedation during a pediatric patient’s regular dressing changes. After the patient’s dressings are changed, there is just enough sedation time for OTs and PTs to perform exercises they might not otherwise be able to do. This practice — known as pediatric ambulatory wound service, or PAWS — was studied at St. Louis Children’s Hospital by the burn center’s former chief surgeon, Robert Foglia, MD. The results were published in the Journal of Pediatric Surgery.

“Being there when they unwrap a patient is so helpful,” says Kate Corrigan, OTR, a dedicated burn unit OT at St. Louis Children’s Hospital. “We can see where the burn is deep and where it is not, and that gives us a clear idea of what help they need. We’re usually in and out in about 15 minutes.”

More Info

Resources

    • American Burn Association: www.ameriburn.org
    • Celis M, Suman O, Huang T, et al. Effect of a supervised exercise and physiotherapy program on surgical interventions in children with thermal injury. Journal of Burn Care & Research. 2003; 24(1): 57-61.
    • Foglia R, Moushey R, Meadows L, et al. Evolving treatment in a decade of pediatric burn care. Journal of Pediatric Surgery. 2004; 39(6) :957-960.
Long-Term Care

At the North Carolina Jaycee Burn Center, where Prochazka works, the OT who assists a pediatric patient on the first day will likely be the primary OT throughout the young person’s inpatient and outpatient treatment.

“When you meet a patient on day one, you are looking at someone who went through a life-altering event and needs a guide, a therapist who can tell them it will be OK,” Prochazka says. “I can tell patients, ‘You are going to be OK … I’ve seen patients with your type of burn.’ If I didn’t see my patients as outpatients six months or a year out, I couldn’t make this assessment with confidence.”

It takes extra communication and commitment from the team to follow pediatric patients all the way through their treatment. While two staff OTs are dedicated to the burn center, there are other OTs trained in burn treatment, as well as OT interns and OTAs, all of whom play a critical role in managing care.

“It really takes a team, because this level of care can wear you out, but it takes this intensity of care to get that great outcome for your patients,” Prochazka says. “Everyone is doing what needs to be done for the child.”

Marnie McLeod Santoyo is a medical writer for the Gannett Healthcare Group. To comment, e-mail oteditor@gannetthg.com.