USMLE Prep - Medical Reference Library

Rehabilitation & Psychosocial Support

System: Burn Surgery • Reviewed: Aug 31, 2025 • Step 1Step 2Step 3

Synopsis:

Rehab starts day 1: edema control, ROM, splinting, mobility, ADL training, and psychosocial support reduce disability and improve return‑to‑work.

Key Points

  • Stabilize ABCs; begin targeted evaluation without delaying life-saving therapy.
  • Use system-specific risk tools to guide testing and disposition.
  • Order high-yield tests first; escalate imaging when indicated.
  • Start evidence-based initial therapy and reassess frequently.

Algorithm

  1. Primary survey and vitals; IV access and monitors.
  2. Focused history/physical; identify red flags and likely etiologies.
  3. Order system-appropriate labs and imaging (see Investigations).
  4. Initiate guideline-based empiric therapy (see Pharmacology).
  5. Reassess response; arrange consultation and definitive management.

Clinical Synopsis & Reasoning

For Burn Surgery Rehabilitation And Psychosocial Support, frame the differential by acuity and pathophysiology, then align diagnostics to the leading hypotheses. Prioritize stabilization while obtaining high‑yield studies such as CBC (Baseline hematology), BMP (Electrolytes/renal). Incorporate bedside imaging and targeted labs to define severity and identify complications; synthesize results with clinical trajectory to refine the working diagnosis and disposition needs.


Treatment Strategy & Disposition

Initiate disease‑directed therapy alongside supportive care, titrating to objective response. Pharmacologic options commonly include Analgesia/Antipyretics. Use validated frameworks (e.g., Rehab Milestones) to guide escalation and site of care. Address precipitating factors, de‑escalate empiric therapies with data, and arrange follow‑up for monitoring and risk‑factor modification; admit patients with instability, high risk of deterioration, or needs for close monitoring.


Management Notes

Coordinate with driver rehab and vocational services. Address pain and itch to enable participation.


Epidemiology / Risk Factors

  • Risk factors vary by condition and patient profile

Investigations

TestRole / RationaleTypical FindingsNotes
CBCBaseline hematologyAbnormal counts
BMPElectrolytes/renalDerangements

Rehab Milestones

PhaseFocus
Acute (ICU)Positioning, edema, early ROM
Post‑opProtect grafts; resume mobility
SubacuteStrength/endurance, ADL independence
OutpatientScar management, vocational rehab
Long‑termCommunity/sport return

Pharmacology

MedicationMechanismOnsetRole in TherapyLimitations
Silver sulfadiazine (topical)AntimicrobialHoursPartial-thickness burnsLeukopenia; sulfa allergy
AnalgesicsPain controlMinutesBurn painSedation
Tetanus prophylaxisVaccine/IG per statusHoursAs indicatedLocal rxn

Prognosis / Complications

  • Prognosis depends on severity, comorbidities, and timeliness of care

Patient Education / Counseling

  • Explain red flags and when to seek emergent care.
  • Reinforce medication adherence and follow-up plan.

References

  1. Burn Rehab — Link