When should ambulation be initiated in the client who has sustained a major burn?
A. When all full-thickness areas have been closed with skin grafts
B. When the client’s temperature has remained normal for 24 hours
C. As soon as possible after wound debridement is complete
D. As soon as possible after the resolution of the fluid shift
Correct Answer: D. As soon as possible after the resolution of the fluid shift
Regular, progressive ambulation is initiated for all burn clients who do not have contraindicating concomitant injuries as soon as the fluid shift resolves. Clients can be ambulated with extensive dressings, open wounds, and nearly any type of attached lines, tubing, and other equipment.
Option A: The consistent finding in the literature is that early ambulation can be safely initiated after lower extremity skin grafting without compromising graft take if external compression is applied.
Option B: Following thermal injury, the innate immune system responds immediately by stimulating localized and systemic inflammatory reactions. The innate immune response participates in activating the adaptive immune response; however, in so doing it has an adverse effect on the burn victim’s ability to mount a vigorous immune response to invading microorganisms and, therefore, predisposes the burn victim to infectious complications.
Option C: Pain control is obtainable by performing therapies during wound dressing and debridement, if possible. Analgesics should also be administered prior to therapy sessions to encourage participation in movement activities.
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