Life Care Planning and Burn Injuries
When evaluating the future treatment needs of an individual who has experienced a burn injury, there are several factors to consider. The treatment course for burn injuries will depend on the mechanism of burn, the depth of the burn, and the amount of the body surface area involved.
Early intervention with appropriate treatment of the burn injury is necessary to avoid complications. Complications could lead to increased medical costs due to the prolonged need for treatment. Complications can include infection, contractures, and hypertrophic banding. After maturation of the scar, even with appropriate initial treatment, additional surgical procedures and rehabilitation may be necessary. Psychological evaluation and treatment may also be needed.
Burn injuries can be caused by exposure to heat, cold, chemicals, electricity, friction or radiation. Depending on the mechanism of burn, there could also be internal injuries such as pulmonary damage due to injury caused by inhalation or destruction of deeper tissues requiring amputation of affected limbs. The tissue most often affected by burn injuries is the skin. Damage to the skin could impact the ability of the body to maintain fluids, regulate body temperature and prevent infection.
Burn injuries are evaluated by the degree or severity of the burn.
First degree (superficial burns) the outer layer of skin is damaged causing inflammation or redness.
Second degree (partial thickness burns) disturbs the first two layers of skin.
Third degree (full thickness burns) extends to the deepest layer of skin.
Fourth degree (deep full thickness burns) extend through the skin to underlying tissues, muscles, ligaments, and bones.
The total burn surface or total body surface area is another significant factor to evaluate. For instance, regarding the initial treatments of a burn injury, skin grafts may need to be performed in stages if there is not enough healthy tissue to perform the graft in one procedure. The total body surface of a burn is classified as minor, moderate or major, depending on the percentage of total body surface area involved.
If a significant amount of the total body surface is affected and if the burn has damaged the sweat glands (occurs at the partial thickness burn level), the individual will have to avoid exposure to hot or humid conditions. This could impact their ability to work in their usual occupation or partake in outdoor activities, especially in hot or humid weather conditions. Depending on the nature of the burn and the physical implications, alternate work situations may need to be explored to mitigate damages related to loss of earning capacity.
A knowledgeable and experienced life care planner and vocational expert engaged to evaluate your case needs will lead to appropriately assessing future care needs and vocational prognosis.
*Weed, R.O. (2009). Forensic issues for life care planners. In Weed, R.O., & Berens, D. E. (3rd Ed.), Life Care Planning and Case Management Handbook (pp. 741-760). Boca Raton, FL: CRC Press.
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Larry S. Stokes, Ph.D.
Aaron Wolfson, Ph.D.
Lacy Sapp, MHS, CRC, LPC, LRC, CLCP
Todd Capielano, M.Ed., LRC, CRC, LPC, CLCP