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Case study
Mr. Smith is a 27-year-old welder who sustained a burn to 8% of his total body surface area during work at a welding company. While welding overhead, sparks got underneath his leather work gloves and ignited his clothes. With the help of a co-worker, Mr. Smith was able to extinguish the fire and remove his coveralls. However, he sustained burns to his right medial bicep, axilla, chest and trunk, and as a result, received a skin grafton the burn areas (donor site: right thigh). Mr. Smith began receiving interdisciplinary outpatient burn rehabilitation services one month following the graft. Good functional progress is evident in his upper extremity (i.e. mobility and strength) and physical endurance, and the burn and donor sites have healed well. However, he continues to experience potential work limitations related to reduced tolerance for bilateral overhead reaching, lifting (currently 70 lbs. maximum), and thermoregulation and hypersensitivity issues in the burn regions. You have been asked to assess Mr. Smith's ability to return to work and develop a return to work plan.
Introduction
Returning to work following a burn injury is a complex process due to various medical (e.g., wound care, physical deformities, psychological and cognitive impairments), social (e.g., worker's and co-workers' expectations, attitudes and beliefs about disability) and environmental factors (e.g., temperatures, equipment/tools, fast-paced and demanding workplace cultures). With their knowledge and skill sets, occupational therapists are well positioned to facilitate effective and safe return to work by integrating knowledge about the person/worker, the occupation and job demands, and the workplace environment, and by liaising with the employer, worker, funding/referral source, and health-care team. The Person-Environment-Occupation Model (PEO) allows interdisciplinary teams to visualize the interactions between person, environment and occupation factors that affect occupational performance (Law et al, 1996). In this paper we use our clinical experience, the PEO Model as a guiding framework and the concepts of 'Ready, Set, Go' to illustrate key factors and processes relevant to return to work practice for clients who have sustained burn injuries.
Getting READY: Understanding personal factors: Body system impairments and functional issues resulting from burns
A burn injury can be caused by a variety of heat sources including hot water, a fire, or an electrocution. Various body systems and functions can...