Oedema management: positioning/elevation
Positioning/elevation is one way that oedema can be managed. See below for the regime, how to implement this intervention and precautions.
Regime:
Commence from time of burn injury
How:
- Elevate limb above the level of the heart so gravity able to assist with oedema reduction.
- Consider the impact of the child’s developmental stage. A baby/toddler is not going to stay in this position so consider how you can use the environment to help with this – e.g. tilt the hospital bed; position toys/games up higher to promote elevated position limb, positions parents can carry/cuddle child).
- Consider splinting in addition to positioning if minimal active movement or risk from oedema to underlying structures (i.e. nerve compression, integrity of joint position).
Precautions/monitor:
- Cognitive status of child and ability to report altered sensations/discomfort from positioning (especially if sedated/unconscious)
- Educate carers/nursing staff to complete regular capillary observations to ensure nil compromise on the child/s peripheral circulation
- If splinting in addition to elevation, splints to be bandaged on as straps may act as a tourniquet and disrupt or impact on circulation.
The photo below shows a 13-year-old boy in Intensive Care after sustaining a 25% TBSA flame burn injury.
Click on each of the purple hotspots for more information on how he has been positioned.
Seek medical guidance if circumferential burn due to risk of compartment syndrome.
