1. The Role of Child Life in the Hospital and Pediatric Burn Unit A presentation by Sherri Shouse, CCLS, Director of Child Life for the Pediatric Burn Unit Hope Children’s Hospital Prince Edward Island, Canada

2. Play Therapy Child’s means of exploring his or her world. Child’s means of exploring his or her world. Able to express emotions Able to express emotions Gives insight into child’s frame of mind Gives insight into child’s frame of mind

3. Socio-Emotional Health Many emotions Many emotions New experience New experience Interruption of life Interruption of life Provide some semblance of normalcy Provide some semblance of normalcy Emotional Stability Emotional Stability

4. Preparation for Medical Services Provide education Provide education Facilitate rehearsal Facilitate rehearsal Encourage autonomy Encourage autonomy Family-centered Family-centered Non-pharmaceutical Non-pharmaceutical

5. Therapeutic Interventions Music Music Art Art Drama Drama Literature Literature Sensory Sensory Symbolic Symbolic

6. Why do we need Child Life? Hospitals can be emotionally traumatizing for many people, especially children. Hospitals can be emotionally traumatizing for many people, especially children. Emotional effects are not always related to the seriousness of a child’s illness. Emotional effects are not always related to the seriousness of a child’s illness. Children express their own feelings through play and make-believe. Children express their own feelings through play and make-believe. When a child is stable emotionally, it is more likely for the child to recover from disease. When a child is stable emotionally, it is more likely for the child to recover from disease.

7. The Role of Child Life within the Pediatric Burn Unit Our hospital has been committed to Family Centered Care and best care possible since 1982 Our hospital has been committed to Family Centered Care and best care possible since 1982 Child Life presence required for all procedures within the treatment room. Child Life presence required for all procedures within the treatment room. Some procedures, such as hydrotherapy, are very important but also very painful. Some procedures, such as hydrotherapy, are very important but also very painful. Assist the child in coping through distraction techniques. Assist the child in coping through distraction techniques.

8. Important Information Regarding Burns First Degree and Superficial Second Degree Burns First Degree and Superficial Second Degree Burns –Resemble a deep sunburn –Heal in less than two weeks on their own. It is not always possible to tell the depth of a burn from a patient’s first admittance. The depth of the burn can increase in severity over the next 48 hours. It is not always possible to tell the depth of a burn from a patient’s first admittance. The depth of the burn can increase in severity over the next 48 hours.

9. Important Information Regarding Burns Second Degree Burns Second Degree Burns –Very painful and can include blistering. These can take more than three weeks to heal. Third Degree Burns –Damage all layers of the skin and require skin grafting to heal.

10. Hydrotherapy Hydrotherapy is the use of water in treatment of illness or injury. Hydrotherapy is the use of water in treatment of illness or injury. The burned child must utilize these tubs in the hospital that allow the cleaning of the burn wounds. The burned child must utilize these tubs in the hospital that allow the cleaning of the burn wounds. The heated water also acts as a sedative. The heated water also acts as a sedative. Germs and bacteria can settle in the wounds or dressings. Germs and bacteria can settle in the wounds or dressings. The hydrotherapy process aids in the recovery of the child. The hydrotherapy process aids in the recovery of the child. The child will likely feel pain due to this treatment. Be honest with them about the pain but keep it simple as you do not want to agitate their nerves even farther. The child will likely feel pain due to this treatment. Be honest with them about the pain but keep it simple as you do not want to agitate their nerves even farther.

11. Dressing Changes Necessary to ensure the wounds are clean and free of bacteria Necessary to ensure the wounds are clean and free of bacteria Distract child with an activity he or she enjoys such as singing a silly song Distract child with an activity he or she enjoys such as singing a silly song Provide support for the child Provide support for the child Encourage compassion for the child Encourage compassion for the child Provide education for the child as to why this is a necessary part of their recovery Provide education for the child as to why this is a necessary part of their recovery

12. Skin Grafting A skin graft is a section of skin that is removed from one area of the body and transplanted to an area that has been injured. A skin graft is a section of skin that is removed from one area of the body and transplanted to an area that has been injured. In small children, the skin is often taken from the back of the skull. In older children and adults, the skin is taken from the inner thigh or buttocks. In small children, the skin is often taken from the back of the skull. In older children and adults, the skin is taken from the inner thigh or buttocks. The graft is spread out on the burned area of the skin and held in place by dressing or stitches. The graft is spread out on the burned area of the skin and held in place by dressing or stitches. The site where the skin was taken, called the donor site, is covered in dressing for 3-5 days to protect from infection. The site where the skin was taken, called the donor site, is covered in dressing for 3-5 days to protect from infection.

13. NG Tubes A nasogastric (NG) tube is inserted through the nose and follows down the esophagus to the stomach. This tube is used to feed a patient with digestion problems until they are able to eat normally. A nasogastric (NG) tube is inserted through the nose and follows down the esophagus to the stomach. This tube is used to feed a patient with digestion problems until they are able to eat normally.

14. Important Points We are here for the patient. We are here for the patient. These children are most likely not sick, they are burned. But we must be careful to not spread infections. These children are most likely not sick, they are burned. But we must be careful to not spread infections. Developing relationships is key Developing relationships is key –Do what is most comfortable for you within your own limitations. Never be afraid to ask questions. Never be afraid to ask questions.

15. picture source To remember….