The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Jan 2004
Randomized Controlled Trial Clinical TrialBurn pain and anxiety: the use of music relaxation during rehabilitation.
Pain and anxiety are well-documented problems during the rehabilitation of patients with burns. This study examined the effect of music on anxiety and pain during range of motion. Eleven subjects with partial-thickness or deeper burns were randomly assigned to a control group (without music intervention) or experimental group (with music intervention). ⋯ Results showed no significant reduction in anxiety and pain during therapy with music relaxation. Limitations included nonhomogenous groups, small sample size, potentially unrepresentative sample, variation in exercise protocol, and small musical selection. Further research is recommended.
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This study examined the relationship among burn scarring, severity and visibility, and body esteem. Previous work addressing this question has relied on case studies and small samples. We mailed a survey to 2500 members of a national burn survivor support group. ⋯ R square for the final equation equaled.62, with social adjustment and depression accounting for the largest portion of the variance. In this sample, burn scar visibility and severity did not have a strong relationship with social and emotional adjustment variables. More effort must be placed into developing psychosocial interventions that help survivors accept scars, reduce depression, and build a strong loving support system.
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J Burn Care Rehabil · Jan 2004
Procalcitonin in pediatric burn patients: an early indicator of sepsis?
To determine whether changes in procalcitonin (PCT) could be used to predict the onset of sepsis, daily PCT levels were monitored in 20 burned children. Analysis indicated a PCT rise of 5 ng/ml or greater as the best indication of sepsis. We compared the surgeons' determination of sepsis, which was based on changes in platelet count, C-reactive protein (CRP), and other clinical manifestations, with the prediction of sepsis from PCT. ⋯ As an indicator of sepsis, the PCT assay had a sensitivity of 42%, a specificity of 67%, and an efficiency of 57%. Even when the assay correctly identified sepsis, the determination was made an average of 0.8 days after the surgeon had already made the diagnosis based on CRP and/or platelet count. We conclude that PCT is not as effective as CRP and/or platelet count in the early detection of sepsis in burned children.
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J Burn Care Rehabil · Nov 2003
Clinical TrialShort-term propofol infusion as an adjunct to extubation in burned children.
Children who require intubation as a component of their burn management generally need heavy sedation, usually with a combination of opiate and benzodiazepine infusions with a target sensorium of light sleep. When extubation approaches, the need for sedation to prevent uncontrolled extubation can conflict with the desire to lighten sedation enough to ensure that airway protective reflexes are strong. The several hours' half-life of these medications can make this period of weaning challenging. ⋯ All were awake at extubation and went on to survive. Morphine and midazolam infusions were gradually weaned, and there were no withdrawal symptoms noted. Although prolonged (days) infusions of propofol have been associated with adverse cardiovascular complications in critically ill young children and should probably be avoided, short-term (in hours) use of the drug can facilitate smooth extubation.
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J Burn Care Rehabil · Nov 2003
Clinical TrialNoncontact electrosurgical grounding is useful in burn surgery.
Grounding patients with large burns to facilitate the use of electrocautery devices during surgery is commonly difficult because of the paucity of available grounding sites. The Mega 2000 Patient Return Electrode System (Megadyne Medical Products, Draper, UT) is an electrode designed to provide electrical return to facilitate function of electrocautery devices without direct patient contact. It accomplishes this by having a very large surface area (720 square inches) in the form of a reusable pad placed on the operating table that is covered by an impermeable drape and clean sheet beneath the patient. ⋯ There were no cutaneous burns observed. No additional traditional devices required placement. We found the device useful in burn surgery in those cases where there is a paucity of traditional grounding sites available.