My experience with burncare (and a little bit of randomosity)

Today I went to the university to print out the notes for the various classes coming up. I think I used up about six trees doing so and it took me almost an hour and I still didn’t finish. I also went clothes shopping since I was badly in need of some new stuff. I had to call Brooke (OT girl) from the mall and ask if Bermuda shorts were still cool. I’m so out of the know in the fashion world. Took a friend swimming and got rained on near the end, it was quite the adventure. Then went to another friends and had REALLY YUMMY beef brisket sandwiches for dinner. Plus they have new chickens and a tame cat, so the chickens & cat were chilling out together. It was fun to watch. After dinner, they told me they had this special homemade ice cream they wanted me to try. They just stuck a spoon in it and said here, try. Well, I was expecting GOOD ice cream and the second it hit my mouth I realized it was not. I had to spit it out and rinse my tongue under the faucet. It was their roasted garlic ice cream, which they thought would taste good but didn’t. Instead of throwing it out after they realized how gross it was, they froze it just so I would have to try it the next time I saw them, their unsuspecting victim. Ew. To make up for it they gave me a caramel brownie. Now I’m home and about to start reading my newly printed OT documents. Okay, on to OT stuff. I wrote the following a few days ago, which is based on an experience I had months ago.

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In the last semester, I got to watch a physical therapist do burn care one time. I know that there are not many OTs who do participate in taking care of burns, but it is still a specialty, so I wanted to share my own experience so that maybe it will help future OT students know some of the things they should be prepared for. I’ve decided HIPAA-vague stories are no fun to read, so I’m going a different route and making ****COMPLETELY fictional characters*** with absolutely no resemblance to who I saw in anyway. Their story is different too. The ONLY thing I’m not changing in this and future stories are my own reactions and feelings, which were pretty intense on this day. The procedure described is routine for burn care.
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My understanding is that many pediatric hospitals have special burn-care rooms. This one was beautiful, with a ceiling full of stars. They do conscious sedation in there when dealing with debridement of burn-wounds and re-bandaging. The day I walked in, I had no clue what to expect since it had actually been a last-minute decision by the therapists to allow me to see it if I wanted to. I said sure and didn’t think twice. I was ushered into a room that was small and filled with people involved in burn-care. A beautiful little girl named Kayla was waiting with her mother. The little girl had been scalded on her leg by hot tap water when sitting on the side of the kitchen sink with her mother, who had not realized how hot the water could get. Kayla’s wound was bandaged and it needed to be examined and debrided. Apparently the little girl had already been given one drug (Versed), but as is routine procedure, Kayla was also given an IV that helped finish off the job of conscious sedation. She of course shrieked when the needle went in, which scared me since I hadn’t realized that was going on at the time. It reminded me of the scene in the Poisonwood Bible when the baby of the family, Ruth, gets bitten by a poisonous snake.

After Kayla had gone limp, she was put on the burn-care table. Her eyes were glassy and she was just completely…gone. It reminded me very much of how my beloved cat, Nikki, had looked when I had to have her put down last summer. After the vets had given her the amnesiac/sedative but before they finished the job, they had let me hold her. I had held her limp body, her eyes glassy and open, and sobbed hysterically. It was one of the worst experiences of my life. (Ok, full disclosure, I’m actually again crying right now thinking of it.) Tears came to my eyes in the burn room because I was reminded of how Nikki had looked (still fresh in my mind from a few months earlier), and also scared me for Kayla. I had not realized conscious sedation would mean they wouldn’t just look like they were “sleeping”.

As the PT and others began to work over Kayla, I watched intently. I had been warned that if I felt dizzy I should sit down but not try to leave. This was partially because they did not want somebody passing out where they couldn’t see them, but I’m going to assume that someone rushing out the door in a small area could potentially blow particles or items onto the open wound by accident, too. As they began cutting away dead flesh and just in general working on debridement, I began to feel sick to my stomach. Not in a throw-up way, just horrified at what I was seeing. They were performing a perfectly routine procedure, going by the book and doing nothing wrong, it just disturbed me to think about the pain associated with burns. I should have known I would feel this way since earlier, when I had seen a newborn being probed with a needle for a blood draw, I had also felt temporarily sick. And it just got worse. I knew I couldn’t leave, so I started to feel trapped. And then I started to sweat. I was getting really, really, really hot. Oh no, that meant I must be having a panic attack. I hadn”t had one in many years. I was desperate to get out of that room into some cool air, to not be trapped watching wound debridement. I knew I couldn’t do anything. I was determined not to make a scene. It would ruin it for future OT students, not to mention make me look bad in that particular instance. Plus, the mother was there. The focus needed to rightfully be on Kayla, not on a freaked out student.

I quietly sat down and turned my head away so I could no longer see what was going on. I cried silently, tears rolling down my cheeks. I was petrified and felt I would pass out if I wasn’t careful. I was fighting the feeling so that I would not cause a disturbance. A nurse who was near me due to the crowded room asked quietly if I was ok, and I nodded. I told her I was fine, just scared. She said that was perfectly normal and that I did the right thing by sitting down. I found out later a lot of students HAVE passed out in there, so my reaction was not that extreme. Luckily Kayla’s burn was not that extensive so the procedure didn’t take too long. Once they started re-bandaging her, I no longer felt so bad. I stood up and observed again and pretended everything was fine. I just felt sheepish because I really thought I could handle it without a problem, so I was kind of mad at myself for doing so poorly. So here are some things you should be prepared for, at least based on my one experience.

1. The child will probably suddenly cry or scream when they get the IV put in. Be aware that’s going to happen (so many people are in the room you can’t see everything) so you aren’t too startled.

2. Be prepared for how the child will look during conscious sedation, since it’s not like sleeping. For me personally, it was worse than looking at a cadaver, but it might not bother most people.

3. They have to keep the room really, really hot because burn victims don’t have skin on the burns. Skin is needed to keep in body heat. So realize you are just hot because it IS hot, not necessarily because you think your body is telling you something.

So..overall, even though it was a horrible experience for me, it was still a good learni
ng experience and fascinating. Nobody did anything wrong, I just didn’t know what to expect and it turned out different factors colluded to make it an unpleasant one. I think if I had known more, I could have handled it differently. Although I don’t think burn care will ever be my passion!

Jul 06, 2007 | Category: Occupational Therapy | Comments: none

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